




M.PE.GRO 










V 



% 4* 














Fig. ii. — Educational clinic of the National Association for the Study 
and Education of Exceptional Children, Plainfield, N. J. 




Fig. 12. — Educational clinic, "Fferbart Hall." Color tests. Tone 

tests. Peg-board. Knox test. Picture cubes. Screen. 

Building windmill, etc. 



THE 
EXCEPTIONAL CHILD 



BY 

MAXIMILIAN P. E. GROSZMANN, Pd.D. 

EDUCATIONAL DIRECTOR OF THE NATIONAL ASSOCIATION FOR THE STUDY AND 

EDUCATION OF EXCEPTIONAL CHILDREN 

AUTHOR OF "A WORKING SYSTEM OF CHILD STUDY FOR SCHOOLS" 

"THE COMMON SCHOOL AND THE NEW EDUCATION" 

"THE CAREER OF THE CHILD FROM THE KINDERGARTEN TO THE HIGH SCHOOL" 

"SOME FUNDAMENTAL VERITIES IN EDUCATION" 

"THE STUDY OF INDIVIDUAL CHILDREN," ETC., ETC. 



CONTAINING A 

MEDICAL SYMPOSIUM 

WITH CONTRIBUTIONS FROM A NUMBER OF EMINENT SPECIALISTS 



CHARLES SCRIBNER'S SONS 

NEW YORK CHICAGO BOSTON 



u-c 



341*^ 



& % 



Copyright, 1917, by 
CHARLES SCRIBNER'S SONS 






NOV 28 1917 




.A4777G1 



THIS BOOK IS DEDICATED TO 

MY WIFE 

WHO HAS NOT ONLY INSPIRED ME WITH THE COURAGE 

OF HER OWN CONVICTIONS 

WITH THE UNSELFISH NOBILITY OF HER DEVOTED SOUL 

BUT WHO HAS GP7EN HER LIFE AND HEALTH 

TO THE WORK WHICH HAS MADE THE WRITING OF 

THIS BOOK POSSIBLE 



FOREWORD 

In discussing the problem of the "exceptional" child, 
these pages employ the term in its broadest sense, as 
a general term in a scheme of classification such as I sub- 
mitted to the educational and medical world a number 
of years ago. In their efforts to find smooth and in- 
offensive appellations for children of mentally defective 
development, some educators and school systems have 
loosely used this term (as they had used the term 
"atypical" previously suggested by me for a special 
group of exceptional children) as a euphonic designation 
of those children who are really abnormal. In this 
book, the term is used strictly in the sense of a general 
term for all types of deviation from the "average." 

The schedule of classification underlying the discus- 
sion in this book is given on page 60. 

The purpose of the book is to give a perspective of 
the entire situation, and to suggest ways and means of 
coping with the problem in its various aspects. It is 
plain that the problem is one which presents more than 
one feature. It is concerned with educational procedure, 
indeed. But the character of the human material which 
is to be educated plays a fundamental part. Thus, 
questions of heredity and family history; of environment 
and social-economic conditions; of child hygiene and 
public sanitation; of medical inspection and clinical 
work; of psychologic and psychopathic investigation, 
and other elements too numerous to state, enter into 



viii FOREWORD 

the discussion. Our investigations will take us into 
juvenile courts and into the hovels of crime and prosti- 
tution; into the almshouses and charity bureaus, and 
wherever humanity's woes and shortcomings are studied 
and methods of relief are considered. 

It has been my endeavor to write the book in simple 
language and in a style which will appeal even to readers 
who have but a modicum of scientific training and 
vocabulary. The average teacher and parent cannot 
be expected to be an expert along the various lines of 
research which are followed in this book. Yet, I hope 
that this book will be helpful to them in opening up 
the problem to their consciousness, and in stimulating 
them to do their share in bringing about possibilities for 
its solution. On the other hand, the material is so pre- 
sented that it gives the reader who is anxious and 
capable to make professional use of it the opportunity 
to do so. An effort has been made to avoid mere asser- 
tions, and to refer in every case to sources and expert 
counsel. The classified bibliography presented at the 
close of the book will facilitate these references. 

I wish to thank those who have assisted me in the 
preparation of the manuscript, by advice and co-opera- 
tion, by encouragement and actual help; who have 
placed their own material at my disposal, and helped me 
with the permission to use their illustrations and cuts; 
also those publishers who have provided large collections 
of their books for my study and information. I am 
particularly grateful to those eminent specialists who 
have given their valuable co-operation in the compila- 
tion of the Medical Symposium. I desire to acknowledge 
the services of my son, Waldemar Heinrich Groszmann, 
who has not only helped in the preparation of parts of 



FOREWORD ix 

this manuscript, but has for years devotedly assisted me 
in my practical work with atypical children. 

May the book find a modest place in present-day 
educational literature, so that it can help where such 
help is needed. 

Maximilian P. E. Groszmann. 

Plainfield, New Jersey, 
September ist, 1917. 



CONTENTS 

PAGE 

Foreword vii 

PART I— THE PROBLEM OF THE INDIVIDUAL 

CHILD 

Chapter I — The Educational Problem in General i 

The Public School and Its Critics, p. i. Public and private schools. Na- 
tional consciousness. Failure of school education. Exaggerated de- 
nunciation. Fundamental objects. Education and National Ideals, 
p. 3. Superficial teaching of history. Tremendous national problems. 
A conglomerate mass of races and peoples. Public School Education 
and Community Problems, p. 5. The business of life. Utilitarianism vs. 
race development. Human by-products. Efficiency. Salvation of 
failures. Excessive cost of caring for human derelicts. The Human Raw 
Material, p. 7. Exceptional children. Potential derelicts. Physical 
defects. The Public School and the Child, p. 10. Individual differ- 
ences. Administrative Problems, p. 10. Shifting of the population. 
Immigration. Equipment. Mass teaching. Extensive vs. intensive 
methods. Repeaters. Wasted expense. Education and the Individual 
Pupil, p. 12. No equality of endowments. Different types. Differen- 
tiation. Small percentage of abnormals. Criminality. The exception- 
ally fit vs. the exceptionally unfit. Many variations. The Problem 
of the Exceptional Child, p. 16. Variation from type as a factor of 
progress. 

Chapter II — The Problem of Efficiency .... 18 

Standards of Efficiency, p. 18. Efficiency experts and efficiency tests. 
Efficiency vs. Skill, p. 18. Definition. Efficiency is the quality of the 
leader. Individual Competency, p. 19. Combination of endowments. 
Potential and actual competency. Hereditary and environmental fac- 
tors. Individual Increment, p. ig. Few individuals produce large 
increments; most people cultivate only a small part of their potentials. 
Types of Men and, Mind, p. 20. Individual combinations. Perform- 
ance levels. Intellectual quality. Complexity of Modern Life Con- 
ditions, p. 21. Rapid changes of conditions. Machinery. Inventions. 
Travel and transportation. Immigrants. Tearing away of old props. 
Competition. Difficulty experienced by the masses. Struggle for ex- 
istence. Skill vs. Efficiency, p. 23. Definition. Ordinary life tasks 
require mostly skill only. Different grades of skill. Skill Quantita- 
tive; Efficiency Qualitative, p. 24. Efficiency and worldly success. 
Community Efficiency, p. 25. Mastery of resources. '"Law and order." 
Higher and more specialized performance levels. Different combina- 
tions in competency. Individual types and community types. Oc- 



xii CONTENTS 

PAGE 

cupation centres. Localization of Industries, p. 26. Narrowing of op- 
portunities. Wage-earners. Loss of potential increments. Restriction 
of variations. Factory Methods, p. 27. Machinery. Minute division 
of labor. Human automatons. Efficiency and National Ideals, p. 29. 
National resources. National competency. Natiohal trend. Demo- 
cratic efficiency still in its infancy. Taking stock of national endow- 
ments. Special interests. National aims to be clearly recognized. 
Democracy and Efficiency, p. 31. Differentiating citizens into groups 
representing types. Cultivation of group and individual endowments. 
Conservation of competency. National Tendencies and the Public 
School, p. 31. Vocational training and guidance. Specialized vs. 
broad education. "Practical" vs. "Cultural" subjects. Skill vs. 
efficiency. The best individual increment is the efficiency increment. 
The Public School and Individual Efficiency, p. 33. Machines vs. human 
beings. Efficiency produces self-realization. National and world ideals. 

Chapter III — Different Civilization Levels in 
Modern Society 35 

Many Different Types of Men, p. 35. Deeper causes of differences. Levels 
of civilization. Primitive Man, p. 36. Impulse. Reflex actions. Early 
human achievements. Small individual increments through long periods 
of time. No "degenerates" among savage peoples. Primitive, or re- 
tarded, development vs. deterioration. Fitting the misfits. Simpler 
Mental Constitutions, p. 38. Modern life handicaps the simpler and 
more primitive mind. Transmission of acquired weakness to offspring. 
Economic pressure causing psychoses. Individual Evolution, p. 40. 
Culture epochs. Periods of development: infancy period, primitive 
period, race period, pubescent period, adolescent period. Different 
rates of speed. Uneven development. Individual combinations. Abo- 
riginal traits vs. modern potentials. Influence of the Environment, p. 44. 
Repression, perversion, lack of exercise and opportunity. Racial dif- 
ferences. Convention. Civilization Levels, p. 45. Reversions to 
type. Modern Reverberations, p. 46. Idea of property, of the sanctity 
of human life. Cruder forms of conduct. Superstitions. Upheavals. 
Selfishness. Gambling. Strata vs. Individuals, p. 49. Survivals. Primi- 
tive recklessness. Composite American Stock, p. 50. Our contemporary 
ancestors. Fragments and relics of bygone times. Mixture of pro- 
gressive and primitive elements. Colored school children. The Amer- 
ican negro. Race differences. Primitive Conduct, p. 54. Mental and 
social maturing. Thought vs. reflex. Panics. Wars. Dissolutions of 
the soul units. Psychopathic conditions. Relapses. Civilization Levels 
and Democracy, p. 56. Difficulty of assimilating the backward types. 
Americanizing the immigrant. The American type. Individual Ad- 
justment, p. 58. Position of the individual in the cultural scale. Varia- 
tions. Period of childhood the starting-point. 

Chapter IV — Classification and Terminology . . 60 

Traditional Confusion in Terminology, p. 60. Arbitrary and indefinite use 
of terms. Classification, p. 60. Normal, subnormal, abnormal children. 
Social strata. Limitations of Classification, p. 63. No absolute classi- 
fication possible. Mixture of types. Normality, p. 64. Normal changes 
in development. A normal child different from a normal adult. Nor- 
mality implies the presence of all human potentials. Potentially Normal 



CONTENTS xiii 

PAGE 

Children, p. 66. Modifications of type. Direction of potentials. Sub- 
normality and Abnormality, p. 67. Subnormals not mental defectives. 
Vagueness of ordinary terminology. Mistaken statements about sub- 
normals and defectives. A Caution, p. 69. Children vs. adults. No 
Rigidity of Types, p. 70. Meumann's rigid types. Effect of training. 
Backsliding. The ascending and the descending scale. Terminology, 
p. 71. Dictionary terms lack precision. Definite content given to 
each term. The Diagram, p. 72. The non-human group: abnormals. 
The typical child. The importance of variability. No "average" chil- 
dren. National types and levels. Variations upward, downward, and 
sideways. Sexual differences. Grades of efficiency and performance 
levels. Neurotics and genius. 

Chapter V — The Normal Child 77 

The Wail of the Well, p. 77. Evil of concentrating on mental defectives. 
Definitions of Normality, p. 78. Negative scales. Method of inference. 
What is a Normal Child? p. 79. School standards. "Average" indi- 
viduals. School Success Not a Safe Standard, p. 80. Conformists vs. non- 
conformists. "Mental Age," p. 80. Scales of intelligence and their fallacy. 
No "Average" Normality, p. 81. Normal individuals differ widely in 
kind. Common sense. Normality vs. Maturity, p. 82. Differences be- 
tween stages of growth. Sex differences. Racial Standards, p. 85. Folk 
and race psychology. Temperamental types. Various Conditions of 
Normality, p. 86. Occupational differences. Efficiency and Normality, 
p. 86. Individual efficiency and competency. Plasticity and capacity 
for growth. Occupational efficiency. Parental efficiency. Social 
efficiency. Cultural efficiency. The normal child must have the ca- 
pacity of healthy growth. 

Chapter VI — Potentially Normal Children ... 90 

Pseudo 'atypical Children, p. 90. Change of Schools, p. 90. Different stand- 
ards in different school districts. Other Causes, p. 91. Slower mental 
and physical growth. "Distinguished dunces." Speed as an element of 
weakness. Illness and accidents. Immigrants. Rapid growers. Neg- 
lected children. Lack of Breadth in School Organization, p. 94. Defects 
of the school vs. defects of the child. Novices as teachers of young chil- 
dren. Professional Training, p. 95. Teachers' training. No training 
for parenthood. Spoiled and miseducated children. Sense Defects, 
p. 96. Unsuspected impairments. Observational Attitude, p. 96. Symp- 
toms must be studied. Causes must be discovered. Distinction be- 
tween fact observed and opinion. Discipline and punishment. Atypical 
Children, p. 97. Sense reactions. Various groups. Neglected senses. 
Blind and Deaf Children, p. 97. Often possessing considerable compe- 
tency. Helen Keller. Danger-signals. Principles of Growth, p. 99. 
Irregularities. Chronological, physiological, anatomical, psychological 
age. Body measurements. Early Observations, p. 100. Opportunities 
of parents. Functional Defects, p. 100. Teeth. Respiration. Heart 
action. Grip. Digestion. Intestinal intoxication, etc. Growing pains. 
Left-Handedness, p. 101. Not necessarily a danger-signal. Speech de- 
fects. Difficulties of the Nervous System, p. 102. Nervous disorders and 
psychoses. Habit-tics. Epilepsy. Hysteria. Children's lies. Retarded 
Brain Development, p. 104. Pathologically retarded growth-rate. Re- 
peaters. 



xiv CONTENTS 



Chapter VII — Exceptionally Bright Children . . 106 

Four groups. First Group: Children Endowed with Good Memory, p. 106. 
Mechanical school work. Often not really bright, but mediocre. Mem- 
ory and skill vs. higher competency. Later failures. Second Group: 
Children of Accelerated Physical and Mental Growth, p. 107. Rapid rate 
of development without pathological precocity. Winifred Sackville 
Stoner, Jr. "Natural Education." Other cases. They need tasks 
commensurate to their strength and advancement. The physical basis. 
Caution. Third Group: Children of One-Sided Development, p. 118. 
Distinct types. Pronounced and unusual gifts. Danger of loss of bal- 
ance. Concentrated potency. Illustrative cases. Fourth Group: 
Children of Neuropathic and Psychopathic Tension, p. 122. Genius vs. 
crank. Psychic defects. Genius and insanity. Criminals. Idiots- 
savants. Wunderkinder. An Early Readt , p. 125. Exceptional visu- 
alization. Motor ideas. The Artistic Type, p. 127. Artists and poetic 
geniuses. Non-pathological genius. The Mathematical Prodigy, p. 128. 
William James Sidis. Other Cases, p. 130. General Discussion, p. 132. 
Normal possibilities. Second breath. The Proper Method at the Right 
Time, p. 132. Nascent periods. Rise of instincts. Suggestion, p. 133. 
Its positive value. Second Breath, p. 133. Overcoming of premature 
fatigue. Unscientific methods of teaching. Increasing the number of 
functioning brain cells. Subconscious Self, p. 134. Space and Time 
Concepts, p. 134. Mere abstractions, or methods of conception. Defy- 
ing time. Anatomical Structure, p. 134. Higher and lower brain centres. 
Automatic, motor, visual memories and their centres. Favorable con- 
ditions of growth. Pathological Complications, p. 136. _ Mortgaged in- 
heritance. Neuropathic tension. Dangers of Artificial Stimulation, 
p. 137. Adolescence. Normal growth a process of maturing. An 
International Problem, p. 138. Japanese researches. Conclusion, p. 139. 



Chapter VIII — Psychopathic Disorders and Psycho- 
pathic Constitutions 140 

Dementia vs. Amentia, p. 140. Absence of mental endowment vs. destruc- 
tion of endowments. Lack of development. Arrest of development. 
Principals Obstal p. 141. Resist the beginnings of mental derangement in 
children. Educational mistakes. Balancing power of ethical standards 
and of emotional discipline. Effect of Injudicious Training, p. 142. Ex- 
cessive instructional demands. Psychopathic delinquents. Early child- 
hood. Various Special Defects, p. 143. Word-deafness and Word-blind- 
ness, p. 143. Speech Defects, p. 144. Various speech centres. Agraphia 
Caused by Auditory Defect, p. 144. Difficult diagnosis. Lichtenheim 
speech schema. Stammering and Stuttering, p. 148. Imitation, habit, 
nervous causes. Defects of Number Conception, p. 14S. Localized de- 
fects. Psychology of number. Counting and space concepts. Me- 
chanical element. Memory defects. Dementia Precox, p. 151. Group 
of symptoms. Predementia precox. Psychopathic personalities. Sexual 
Neurastheniac. 151. Sexual precocity. Pubertal development. Group 
of symptoms. Prostitution. Other Psychopathic Symptoms, p. 152. 
Fatigue. Timidity. Negativism. Excessive reaction. Frights. Tan- 
trums. Illusions, etc. Tics. Vasomotor disturbances. Balance. Tro- 
phic disturbances. Illustrative Cases, p. 154. The Educational Clinic, 
p. 158. Psychopathic clinics. 



CONTENTS xv 



Chapter IX — The Feeble-Minded Group . . . .159 

Vagueness of Definition, p. 159. Various attempts at definition. Amentia 
vs. Dementia, p. 161. Difference between the insane and the feeble- 
minded. Difference between dulness and feeble-mindedness. Common 
sense. Feeble-Mindedness vs. Retardation, p. 162. Confusion between 
retarded and arrested development. Causes of retardation. Inade- 
quacy of "Mental Age," p. 165. Idiots, imbeciles, morons. Moral im- 
beciles. Industrial classification. Factor of growth. Growth periods. 
Stretching the Binet scale. Arguing in a circle. Specific tests. Feeble- 
Mindedness vs. Primitiveness, p. 170. Feeble-minded may be trained in 
skill, but not intellectually improved. Civilization levels. Negroes, 
Indians, Eskimos, etc. Are lower races comparable to the feeble- 
minded? Feeble-Minded vs. Lower Strata, p. 173. Environmental con- 
ditions. Basic disorders. Retarded groups. Exploiters of the weak. 
Necessary Distinctions, p. 175. The term feeble-minded is deceptive. 
Factory methods and skill. Disposition of the lower levels. Problems 
of democracy. Human machines to be replaced by real machinery. 
Uplift of the submerged. The function of the aments. Methods of 
Diagnosis, p. 178. Development of right criteria. Benefit of the doubt. 
Difference of reaction in adults and children. Observation classes and 
schools. Physical tests. Mental tests. Common sense. Illiteracy. 
Judgment. Characteristics of the feeble-minded. The Prayer of the 
Defective Child, p. 183. 

Chapter X — Juvenile Delinquency 185 

What is Crime? p. 185. Law vs. crime. Artificial offenses. Success as a 
criterion. The Veneer of Civilization, p. 187. Primitive modes of living. 
Man's Inherent Savagery, p. 187. Civilization still shallow. Cruel 
treatment of offenders. War and the Primitive, p. 189. The God of 
Battles. The psychology of war. Promptings to return to the primi- 
tive. Reverberations of Primitive Instincts, p. 191. Conceptions of right 
and wrong. Business ethics. Child labor. Souvenir craze. Gambling. 
Racial Elements, p. 192. Different moral and mental attitudes. Tor- 
tuous mental methods of Orientals. Black Hand. Chinese societies. 
Harikari. Juvenile Offenders, p. 193. Caution in treating the problem. 
Delinquency and Feeble-Mindedness, p. 193. Moral imbeciles. More ac- 
tive delinquency in the higher grades of mental defect. Percentage of 
feeble-minded offenders small. The dangerous criminal is intellectually 
endowed. Psychopathic Personalities, p. 197. Many youthful delin- 
quents victims of neurasthenic disorders. Adolescent perversion. 
Epilepsy and Crime, p. 199 Padded cells. Epileptic colonies. Famous 
epileptics. Medical Relief, p. 199. Treatment and surgery. Primitive 
Types, p. 200. Reassertion of primitive instincts. Customs in ancient 
and modern times. Reverberations of aboriginal cruelty. Different 
codes of ethics. Economic Conditions, p. 202. Poverty. Lack of recre- 
ation. Lack of privacy. Slum conditions. Cruelty to children. 
Economic helplessness. Idleness. Majority of juvenile offenders hon- 
est and willing to work. An Interesting Bit of Statistics, p. 204. Small 
percentage of mental defectives. The Problem of Truancy, p. 204. 
Misfits. Faulty home conditions. Wanderlust. The barefoot boy. 
Periods of change. Psychopathic nomadism. Children's Lies, p. 207. 
Many causes. Few are abnormal and morally reprehensible. Constitu- 
tional liars. Misconceptions of Normal Conditions, p. 209. Natural 



xvi CONTENTS 

PAGE 

order in the awakening of impulses. The child's standard. Normal 
toughs. Difference of home conditions. Weak Wills and Unsocial 
Instincts, p. 210. Temptations. Prevention. Opportunity for social 
endeavor. Pronounced individualism. Unwritten law. Conclusion, 

E. 212. Knowledge of conditions necessary. Reform of methods of 
andling juvenile offenders. 

Chapter XI — Sexual Perversion and Prostitution 213 

Prostitution and Feeble-Mindedness, p. 213. Small percentage of aments. 
Silly, voluptuous girls. The Tragedy of Woman's Life, p. 214. The 
girl's hazard vs. the man's escape. A new social conscience. Puritan- 
ism is not normality. Ignorance and Prudishness, p. 215. Sexual de- 
railment can be prevented. Children's ignorance; parents' lies. Sexual 
Education vs. Sexual Hygiene, p. 216. Training in good habits. Truth. 
Spiritual vs. physiological truth. Stages of intellectual growth. Crea- 
tion in religion. Sexual polarity. Mere knowledge is not virtue. 
Home and Its Influences, p. 218. Right relations. Spiritual atmosphere. 
Parents to tell the secret of life. Marital Choice, p. 218. The marriage 
market. Promiscuous Relations of Children, p. 2ig. Streets and 
games. The darkened parlor. Tenement Conditions, p. 2ig. Naive con- 
ceptions in southern countries. Lack of privacy in slums. Morbid 
Sexuality, p. 219. Awakening of sex instinct. Masturbation. Inver- 
sion. Early Intercourse, p. 221. Early marriages. The first "fall." 
Former concepts less refined than modern ones. Ancient Sex-Worship, 
p. 222. Prostitution and inebriety in relation to ancient religious 
practices. Racial Differences and Their Modern Counterparts, p. 223. 
Curious family arrangements. Malpractice with Children, p. 225. Re- 
lapses into savage habits. Demented offenders. Causes and Remedies, 
p. 227. Causes vary. Improvement of educational procedure and 
social conditions. Illegitimate Offspring, p. 227. Few prostitutes have 
offspring. Superiority of illegitimate children. Conclusions, p. 228. 
Guard the child's sexual life. Warm-blooded appreciation of con- 
ditions. 

PART II— THE PROBLEM OF CLINICAL RESEARCH 
AND DIAGNOSIS 

Chapter XII — The Determination of Exceptional 
Development in Children 230 

Different Methods of Testing, p. 230. Obscurity of terminology. Mislead- 
ing findings due to loose methods of testing. Erroneous percentages of 
feeble-mindedness. The true percentages. Hereditary and Congenital 
Data, p. 231. Causes of exceptional development. Doubtful value of 
some heredity charts. Need of a national system of vital statistics. 
Co-operation of the medical fraternity. Mental Status of the Child, p. 
232. A mere "scale of intelligence" insufficient. Fallacy of pseudo- 
exactness. The Author's Own Larger System of Tests, p. 233. General 
divisions. Child History Data, p. 233. Etiological statements. Family 
data. The child's own history. Description of the child. Physical 
data. Functions. Moral status. Peculiarities and habits. Mental 
status. General symptoms. Body Measurements, p. 234. Anthropo- 
metric data. Pulse, respiration, temperature. Special observations. 



CONTENTS xvii 

PAGE 

Medical Examinations, p. 234. Cross-section examination. Laboratory 
tests. Anatomical data. The skeleton. Musculature and character- 
istics. Functional tests. Regimen and diet. Disease and treatment 
record. Educational Tests, p. 237. Tests of intelligence and judgment 
vs. tests of physiologic function. Physio psychological Tests, p. 237. 
Vision. Hearing. Touch. Taste. Smell. Location. Balance. 
Mental Tests, p. 238. Counting, naming, association, judgment, co-or- 
dination, expression, etc. Arrangement in Periods, p. 238. Biological 
factors of growth. Periods of development. Five periods. No hard and 
fast lines. Retardations and accelerations. Conditions of Testing, p. 
240. The series not intended for general office practice. Shorter clinical 
set of tests. Fallacy of rapid tests. Observation clinics. Tests may 
take the place of traditional school examinations. Use in special in- 
stitutions for exceptional children. Instructive Cases, p. 242. 

Chapter XIII — As to Standardization 248 

Tendency to Establish Standards, p. 248. Quantitative terms. The work of 
the statistician. Standardization of Mental Tests, p. 248. The popular- 
ity of the Binet Tests. Computation of "mental age." Difficulties En- 
countered, p. 248. Difference in mental type vitiates age standards. 
Even a division in periods can never be absolute. Hesitation of the 
author to standardize his tests. Placing of Details, p. 249. Particular 
performances may be graded. Fallacy of "formal training " idea. Tests 
will reveal performance levels. The Personal Equation, p. 250. It enters 
into the valuation of results. Tests Merely Methods of Approach, p. 251. 
Complex nature of the child. The variable elements of schooling and 
education, of environmental conditions and personal experience. 

Chapter XIV — The Binet Scale of Intelligence . 253 

Its Value for Comparison, p. 253. Employed by author in Huey's modified 
form, with certain amendments. Tlte Author's Amendments, p. 253. 
Goddard's pictures. Enlarged drawings. Money test. Questions of 
comprehension. Nonsense sentences. Criticism of Binet Tests, p. 255. 
Language Tests, p. 255. Differences of type and opportunity. Effect of 
school training. Color Tests, p. 257. Color perception and verbalization 
of color. Weight Test, p. 258. Indicates a special kind of intelligence. 
Repetition of Words and Numerals, p. 258. Merely a memory test. 
The Test of Sixty Words, p. 258. It depends upon the verbal type. Binet 
Results and School Standing, p. 259. Its elusive value. Mechanical 
Compulation, p. 259. Its inadequacy. Mental Age and Judgment, p. 
262. Confusion of terms. Binet Tests and Feeble-Mindedness, p. 262. 
Contrasting views. Judgment of the Examiner, p. 263. The scale is not 
an automatic weighing machine. Mental Quality, p. 264. Not mea- 
sured by Binet scale. Other Admissions by Binet-Simon, p. 265. What 
is Intelligence? p. 265. Confusion of elements. The common sense of 
the examiner. 

Chapter XV — The Meaning of an Educational 
Clinic 268 

Various Kinds of Clinics, p. 268. Psychological departments of univer- 
sities. Medical clinics. Psychopathic clinics. Genetic Psychology and 
Child Study, p. 269. Child study in its broader sense goes beyond 
psychology. Medical inspection. The Psychological Clinic, p. 269. 



xviii CONTENTS 

PAGE 

Its functions. Children as study types. Research work. Investiga- 
tions along specific lines. The Psychopathic Clinic, p. 271. Difference 
between amentia and dementia. Medical Clinics, p. 272. Various 
kinds. Their special functions. Sociological and Ethnological Research, 
p. 272. Environment and social conditions. Family life. Race and 
color. The Educational Clinic, p. 273. For the individual child and 
his problem. The educational view-point. The expert edvcator. His 
limitations. Co-ordination with medical inspection work. Reaching 
out to all children, even in villages and rural districts. System of 
Tests, p. 274. Simplification of schedules. Inexpensive equipment. 
Testing to be done by well-trained teachers and school officers. Net- 
work of Clinics, p. 275. Educational clinics to be feeders for the more 
centralized psychological, psychopathic, and medical clinics. Ar- 
rangements for private schools, social centres, juvenile courts, etc. 

Chapter XVI — Schedule of Tests 276 

Completer Schedule, p. 276. "The Study of Individual Children." The 
Briefer Schedule, p. 276. Simple and inexpensive. Attractive environ- 
ment. Child History, p. 278. Detailed explanations. Conditions of 
birth. Diseases. Moral status. Special characteristics and tendencies. 
Mental status. School record. Physical Examination, p. 283. Height 
and weight. Lung capacity, grip, push. Tables for comparison. 
Vital capacity. Other findings and recommendations of the examining 
physicians. Educational Tests, p. 291. Distinction between tests of 
physiologic and psychologic function, of individual experience, and of 
effect of school training. Visual Tests, p. 295. Visualization of prob- 
lems. Distance tests. E-fork tests. McCallie's vision tests. Color 
perception. Color blindness. Naming of colors. Visual memory. 
Auditory Tests, p. 304. Distance. Identification tests. Pitch. Audi- 
tory memory. Word -pictures. Tactile Tests, p. 311. Physiological 
integrity of the tactile sense. Faculty of interpreting percepts. Experi- 
ence. Sense of Smell, p. 312. Identification and acuteness. Sense of 
Taste, p. ^14. Recognition and acuteness. Motor Co-ordination, p. 
314. Threading needles. Sense of Location, p. 315. Muscular sense. 
Balance, p. 316. Disturbances in the static apparatus. Train of Ideas, 
p. 316. Three circles of experience: occupations, school, home. Imi- 
tation, p. 317. Movement. Knox Tests. Peg-board. Concentration, 
p. 321. Following directions. Remembering objects. Test of 100 A's. 
Naming of Objects, p. 324. Pictures. Language, p. 325. Story told 
from picture. Written reproductions. Completion test. Ciphers, 
puzzles, secret languages. Opposites. Classification. Reading, p. 334. 
Writing, p. 334. Copying, spelling, composition. Number Concept, p. 
336. Counting. Space conceptions. Courtis Tests. Problem in judg- 
ment. Puzzles. Discrimination, p. 347. Matching pictures. Com- 
paring lines. Picture arrangement. Illusions. Construction, p. 349. 
Form boards. Reconstructed pictures. One hundred dots. Color 
cubes. Anchor puzzle. Building blocks. Construction of houses. Me- 
chanical construction. Expression, p. 359. /Esthetic attitude. Art 
instinct. Parallelism between children's art work and that of savages 
and ancients. Drawing, painting, modelling. Minimum Requirements, 
p. 364. Abbreviated set for rapid testing. Summary, p. 366. Response. 
Fatigue. Individual experience. Period of development. Educational 
status. Avoidance of generalized conclusions. Suggestions for in- 
dividual cases. 



CONTENTS xix 

PART III— THE PROBLEMS OE PREVENTION, AD- 
JUSTMENT, AND ORGANIZATION 

PAGE 

Chapter XVII — The Problem Stated — Its Per- 
spective 372 

Various Aspects, p. 372. Variations vs. deviations. Adjustments in home 
and school. Four aspects: normality, opportunity, measures of relief, 
prevention. Various Provisions, p. 374. New standards. Legal status 
of child. Eugenics. Home life. Ethical and religious elements. En- 
vironment. Scientific valuations of individual children. Medical ex- 
aminations. Professional training of parents, teachers, social workers. 
Adjustment of school curricula. Ample space and opportunity. In- 
stitutional schools. Custodial care. Forest schools; farm schools; 
camps. 

Chapter XVIII — Legal Provisions for Exceptional 

Children 380 

Compulsory Education Laws, p. 380. States not having such laws. Racial 
segregation. Non-compulsory States do not exclude any class of chil- 
dren; compulsory States exclude the "physically and mentally unfit." 
Failure to Provide for Excluded Children, p. 382. Poverty plea. The 
delinquent child. Truants. Children's Courts, p. 385. Probation sys- 
tem. Legal Provisions for Subnormal and A bnormal Children, p. 386. 
Deaf. Blind. Incorrigible. Delinquent. False economy practised by 
legislative bodies. The policy of "laisser aller." Extension of Ike Com- 
pulsory Education Laws, p. 388. N. E. A. resolutions. Chronological 
age vs. maturity. Control of mentally immature persons by society. 
Modifications of law of majority. 

Chapter XLX — Eugenic Considerations, Marriage, 
and Heredity 393 

Scarecrow Eugenics, p. 393. The world not a stock-farm. Complexity of 
problem of heredity in human matings. Restriction of Marriages, p. 394. 
A two-edged sword. Love defies reasoning God-given, it is a reliable 
guide to selection. Makeshift laws. Venereal diseases to be made re- 
portable. Sexual Education, p. 396. Hysterical sensationalism. Sad 
effects of improper sex instruction. A problem of the home. Steriliza- 
tion of the Unfit, p. 398. Segregation vs. sterilization. Who are the un- 
fit? Baffling facts. Feeble-mindedness and heredity. Collection of 
Data, p. 401. Overestimation of the feeble-minded danger. Methods 
of collecting data faulty. Unreliability of family histories. Construc- 
tive Methods, p. 404. Most "misfits" can be saved. Direful effect of 
sensational propaganda. Positive vs. negative methods. Early mar- 
riages of the fit. Practical Eugenics, p. 406. Responsibility implied in 
marriage vow. Caution in selecting life partner. Evil of headlong 
marriages. The divorce evil. Overcoming of hereditary tendencies. 
Early Marriages, p. 408. Economic pressure tending to postpone mar- 
riage. Unwillingness to accept marital duties. Love of luxury. Evil 
of postponement. 



xx CONTENTS 

PAGE 

Chapter XX — Home Life and Home Education . 410 

Unwelcome Children, p. 410. Abortion. Regulation of births. Still- 
births and miscarriages. The Sacrament of Matrimony, p. 411. Re- 
sponsibility of parenthood. Health of the Prospective Mother, p. 412. 
Starved working girls. Gay women. Proper nutrition and exercise 
during pregnancy. Emotional and mental condition. The father's 
part. Care in Labor, p. 414. Midwifery. Infection in labor. Obstetric 
physicians and nurses. Maternity hospitals. Care of mother and 
child. A Healthy and Happy Home Life, p. 415. Woman the home- 
maker. Family hotels. Most homes are for adults, not for children. 
Children in the way. The Profession of Parenthood, p. 416. Parental 
functions must be learned like any other business. Complex conditions 
of modern life. Doll play. Herbert Spencer's and Frobel's demands. 
Parents' and mothers' clubs. Schools of mothercraft. Fundamental 
Realities, p. 418. The home is for the child. Heredity and environ- 
ment. Hereditary Elements, p. 418. Child the last link of a long chain. 
Infinite variations and combinations. Effect of imitation. Environ- 
mental Factors, p. 420. The passive environment. Example, tradition, 
experience. The social atmosphere. Spirit of the community. Pol- 
itics and graft. Child labor. Children Are Not the Property of Their 
Parents, p. 422. Children's rights. Individualization in the Home, p. 
424. Justice means recognition of differences. Child study. Education 
in the Nursery, \>. 425. A world in miniature. A laboratory. Opportu- 
nity of parents. Education through play. Children s Growth and Health, 
p. 427. Light, fresh air, freedom, and nourishment. Infant mortality. 
Malnutrition a potent cause of abnormal development. Fatigue period. 
Pubescence and adolescence. Infectious diseases. Danger-signals. 
Hygiene of the nursery. Abnormal Developments, p. 430. Various 
causes. Misunderstanding a Child, p. 432. Adult standards out of 
place. Truthfulness and Obedience, p. 432. Causes of children's lies. 
Obedience is not a duty, it is a result. A True Family Government, p. 433. 
Discipline to be adjusted to the varying needs of growing children. 
A home democracy. Mutuality. Confidence between parent and child. 
The True Home Spirit, p. 436. The most potent educational factor. 
Human vs. divine fatherhood. The memory of a happy childhood. 
The City and Her Boys, p. 438. 



Chapter XXI — School Problems 439 

A Powerful Arraignment, p. 439. Criticism of present-day school educa- 
tion. Fundamental Verities, p. 440. Civilization has not come through 
books. Philosophy of the tool. First-hand vs. vicarious experience. 
Different types of efficiency. An Experiment and Its Lessons, p. 442. 
A school without the Three R's. The Springfield papers. Another 
Experiment: The Play School, p. 445. The University of California's 
experiment. Classification of activities. ^4 Contrast, p. 447. State 
examination questions for public-school graduates. Unprofitable, 
superficial, and ill-adjusted work. Essentials vs. unessentials. The 
"common branches." Home work credits. Differentiation of cer- 
tificates. The Problem of Methods, p. 451. Errors and abuses in method. 
Artificial production of stupidity in schools. The first steps most im- 
portant. 



CONTENTS xxi 



Chapter XXII — The Kindergarten Period . . .455 

A New Gospel of Freedom, p. 455. A new outlook. Disappointments. 
Tyro teachers. Genetic Psychology vs. Stereotyped Forms, p. 455. Two 
great mistakes. Uniform Standards, p. 456. Rigidity of practice. Too 
much group work. Traditional patterns. Penalty of Success, p. 456. 
Classroom arrangement. The child prematurely civilized. Primitive 
tendencies. The Young Child Is Individualistic, p. 457. Socializing a 
slow process. Montessori Influence, p. 458. Not a new practice. The 
teacher as an observer. Racial Differences, p. 459. No mere copying 
allowable. Individual Types of Mind, p. 460. Even babies differ in 
type. Differences in Growth Rate, p. 460. Diversity of speed. Mental 
Attitudes and Aptitudes, p. 460. Originality vs. imitativeness. Misun- 
derstanding of children of initiative. Conventional Symbolism, p. 461. 
Drawing and sewing in outline. Pictography. The teacher as an ex- 
ample. Illustrative Cases, p. 463. The kindergarten at "Herbart 
Hall." The Kindergarten Principle, p. 464. Principle vs. practice. 
The Montessori Cult, p. 464. No new principles. The Principle of 
Freedom, p. 465. The child the real centre of instruction. German edu- 
cation. Frobel and Pestalozzi. Wise Teachers Required, p. 466. A sore 
need. Objectivity of Instruction, p. 466. Sense training. Didactic ma- 
terial. Facts vs. Imagination, p. 468. Montessori's mistake. Culture 
Epochs, p. 468. Montessori's admission. Her failure to appreciate the 
meaning of this development. Premature Scholastics, p. 469. Early 
reading and writing. Methodical Devices, p. 470. Clever practical ma- 
terial. An Ideal Plan for the Kindergarten Period, p. 471. Atmosphere 
of freedom and encouragement. Outdoor work. Learning by doing. 
Virility. No lockstep. Touch with real life. Enfranchised individuals. 

Chapter XXIII — General Provisions for Varia- 
tions from Type and for Deviations from the 
Normal 474 

Proper Diagnosis the First Requisite, p. 474. Educational clinic. Medical 
inspection. Objects of Medical Inspection, p. 476. Prevention of develop- 
ment of disease or physical derangement. Recognition of existing phys- 
ical difficulties. Removal of ailments, and co-operation in overcoming 
educational and vocational handicaps. Need of well-trained inspectors, 
school nurses, and social visitors. Repeated Examinations, p. 478. Chil- 
dren change often. Forestalling derailments. Co-operation with the 
home. Observation classes and schools. System of Clinics, p. 479. 
Pathological laboratories. Psychological clinics. Vocational aptitudes. 
Psychopathic clinics. Orthopedic work. Open-air schools. Clinics 
for Delinquents and Dependents, p. 479. Examination of children in 
courts, detention homes, charity organizations, etc. Medical Aspect, 
p. 480. Medical symposium. 

Chapter XXIV — Provisions for Exceptional Chil- 
dren in Schools and Institutions 481 

Special and Ungraded Classes, p. 481. Confusion of terms. Dumping- 
grounds. Repeaters. Ungraded Classes, p. 482. Misused for defectives. 
Their true function to serve pseudoatypical children. Smaller regular 
classes. Special Classes, p. 483. For observation and "special" chil- 



xxii CONTENTS 

PAGE 

dren. Various Types of Special Classes, p. 484. Children difficult of 
management. Children of special aptitudes and difficulties. Children 
of unusually rapid or unusually slow development. Cautions. Insti- 
tutions (or Atypical Children, p. 485. Insufficiency of private tutorship. 
Sanatorium treatment. As to Methods in Special and Ungraded Classes, 
p. 487. Suggestions from clinical findings. Obstruction of re-education 
through conscious effort. Motor training. Objective methods. Dis- 
cipline. Taking child on his own terms. Attention, interest, and joy. 
Habit training. Truants and Incorrigibles ; Juvenile Delinquents, p. 4gi. 
The visiting teacher. The new truant officer. Enforcement of com- 
pulsory education laws. Reform of the reform school. An educational, 
not a penal problem. Abnormal and Feeble-Minded Children, p. 496. 
Day classes do .not solve the problem. A makeshift arrangement. 
Custodial care cheaper and more effective. Special Provisions, p. 501. 
Classes and schools for the blind, deaf, anaemic, tuberculous, crippled. 
Open-air schools. 



Chapter XXV — Sanatorium Schools for Atypical 

Children 504 

Purpose of the Sanatorium School, p. 504. Tests and Records, p. 504. 
Correlation of educational and medical science. A continuous child 
history. Daily Life, p. 506. Home atmosphere. Personal hygiene and 
self-care. Discipline. School lessons. Planning of individualized in- 
struction. Instruction and Methods, p. 508. No patent methods. Ob- 
jective and creative methods. Native experience. Course of study. 
Methods of presentation. Sense training. Articulation. Music. 
Physical training and games. Art work. Manual training. Typical 
occupations and tools. Shop work. Laboratory work. Sewing and 
needle work. Domestic work. Nature study. Geography. History. 
Number, space, and form. Language teaching. Reading and litera- 
ture. 



Chapter XXVI — The Training of Teachers . . . 533 

The Teacher as an Essential Factor, p. 533. Self-adjustment. Differences 
of types in teachers. Appreciation of differences in children. The 
Teacher's Function, p. 534. True teaching prepares for right living. 
Meaning of Education, p. 534. Essential considerations. The Child's 
Point of View, p. 535. The child's mental vision. His apperceptive 
basis. Misunderstandings and their causes. Qualitative Differences of 
Subjects, p. 536. Variations in their power to appeal to a child. Differ- 
ent mental processes. Native Differences of Individuals, p. 536. Emo- 
tional qualities. Mental types. Intricacies of the child soul. The 
teacher must reach his pupils. Specialization in Teaching, p. 538. 
Advantages and drawbacks. Primary teaching a delicate problem. 
Individual teacher personalities. Review of a Suitable Curriculum, p. 
539. Classification of child types. Teaching as a profession. Selection 
of special field. Revision of the teaching of "methods." Personal 
equation. Revision of educational psychology. Practical experience 
with children, also outside of classroom. Broad training in physiology 
and hygiene. The medical attitude. Training of Teachers of Excep- 
tional Children, p. 543. Subdivisions. Differentiation of courses. 



CONTENTS xxiii 



Chapter XXVII — Conclusion 545 

Survey of principal parts of book. Dreams of perfection. Individualiza- 
tion not a cult of flabbiness. Kant's categorical imperative. To thine 
own self be true. 



APPENDICES 

Appendix I — The City and Her Boys. By Albert 

B. Hines 549 

Classification, p. 549. The boys of wealth, of the middle class, of the 
semi-functioning homes, the homeless boys. The City's Duty Toward 
the Boy Problem, p. 550. A child-welfare department. Streets, parks, 
recreation centres. Civic responsibility. Street Life, p. 550. A test 
of exposure. Play the child's pitfall. Unguarded leisure time of the 
street children. Street land. Ten thousand truants in New York. 
Adult solicitors. Boys' street trades. The Law, p. 552. A natural 
enemy of the boy. Probation officers. Children's courts. Big Brothers 
and Big Sisters. School retardation. Delinquency. Recreation, p. 554. 
Insufficiency of provisions. Element of excitement. Imitation of 
crime in games. Winning by unfair means. Settlements. Social 
centres. Motion-pictures. The Part of the Schools, p. 556. Neglect of 
their opportunities. They should make thinkers of the boys. Used 
only 40 per cent of the time. The Church, p. 556. Adolescence, the time 
of sex development, equally fertile for the development of crime and 
of the religious life. Church a negative factor. The religious motive. 
Church responsible for its own environment. Boy needs a religion 
natural to him. The Working Boy, p. 558. Vocational guidance. 
Monotonous labor causes craving for excitement. Unwholesome amuse- 
ments. Club life vs. dance-halls. Civic efforts. The Unclubbed Boy, p. 
559. The homeless boy has few chances. Little provision for the re- 
tarded, the adventuresome, the defective, and the delinquent boy. 
The mentally defective is very suggestible and therefore apt to be the 
tool of intelligent criminals. 

Appendix II — A Medical Symposium 562 

Introduction, Dr. Abraham Jacobi's blessing, p. 562. 
I — General Procedure, by Dr. A. Emil Schmitt, New York, p. 563. 
Co-operation of teacher and physician. Examinations. Schedule. 

II — Physical Causes of General and Mental Deficiencies, by Dr. 
Thomas D. Wood, New York, p. 567. Statistics of physical defects. 
Dental defects. Country children more handicapped. Physical de- 
fects interfere with mental development. Early detection of defects. 
Necessary provisions. Present status of health service. Mentally 
backward and deficient children. 

Ill — Prenatal and Natal Causes of Exceptional Development in 
Children, by Dr. Ira S. Wile, New York, p. 571. Beginning of life. 
Exceptional development. Heredity and environment. Redemption 
of childhood. Special defects. Racial immunities. Other intrauterine 
anomalies. Care of the prospective mother. Natal causes. Adjustment 
to individual needs. 



xxiv CONTENTS 

IV — Medicoeducational Methods in the Treatment of Atypical 
Children, by Dr. C. Hudson-Makuen, Philadelphia, p. 575. Medico- 
educational methods. Principles of eugenics. The medicoeduca- 
tionalist. Psychological conditions. Mind and brain. Difference be- 
tween normality and abnormality. Psychophysical education. Con- 
centration. Two important elements. Correct postural attitudes. 
Correct breathing. Speech training. A forcing process. 

V— Malnutrition, by Dr. Ira S. Wile, New York, p. 579. Definition 
of malnutrition. Extent of malnutrition. Causes of undernourish- 
ment. Effect of malnutrition. Nutrition records. Interdependence 
of conditions. Solution of the problem. Determination of malnu- 
trition. 

VI — Clinical Studies and Observations in the Mouth or the Ex- 
ceptional Child, by Dr. Arthur Zentler, New York, p. 583. Oral 
hygiene. Meaning of oral hygiene. How early should care of mouth 
begin? Wrong alignment. Other pathological manifestations. The 
mouth as a cause of retardation. Mouth breathing. Bottle-feeding. 
Illustrative cases. 

VII — Habitual Constipation, by Dr. B. Onuf, Park Ridge, N. J., p. 
590. Constipation and exercise. Mental attitude in defecation. The 
psychic factor. 

VIII — Deformities in Children, by Dr. E. H. Arnold, New Haven, p. 
592. Classification. Etiology. Diagnosis. Treatment. 

IX — The Role of Neuromuscular Education in Training Atypical 
Children, by Dr. C. Ward Crampton, New York, p. 596. Three 
parts of conscious reaction. Handicap of habits. Processes of deal- 
ing with the handicaps. Process 1 : Strengthening weak powers. 
Process 2: Objective-subjective methods. 

X — The Influence of Breathing and Speech upon the Child's 
Mentality, by Dr. Otto Glogau, New York, p. 599. Speech and 
breathing. Faulty breathing. Mechanism of respiration. Human 
breathing a reflex action. Inarticulate sounds also reflex in nature. 
Breathing and articulate speech. Process of speech. The psychic 
mechanism. Normal breathing. The two types of breathing. Rela- 
tion of normal breathing and normal speech. The abnormal breathing 
of the stutterer. Abnormal breathing as a cause of psychic disturbance. 
Defective hearing and speech troubles. Other causes of speech dis- 
turbances. Correction of speech defects. 

XI — The Deaf Child from the Standpoint of the Educator, by 
John Dutton Wright, New York, p. 610. Classification. Effect of im- 
pairment of the auditory sense. Need of early diagnosis. Educational 
treatment. Home care. The second group. Lip-reading. The 
third group. The fourth group. Occupations for the deaf. Surround 
the deaf with normal conditions. Methods of teaching. Deaf children 
with defective mentality. 

XII— The Blind Child, by Dr. F. Park Lewis, Buffalo, N. Y., p. 618. 
Fundamental needs. Early recognition. Early impressions. School 
training. Need of normal companionship. Some remarks on method. 
Varieties of work. Amusements and special inventions for the blind. 

XIII — Hereditary Weakness Predisposing to Tubercular Diseases 
and Its Prevention, by Dr. Theodore Toepel, Atlanta, Ga., p. 626. 



CONTENTS xxv 

Predisposition vs. heredity. Systematic habits of living. Exercise. 
Stimulants. Mouth hygiene. Breakfast. Professional precautions. 
Other matters of daily routine. Special precautions. Conclusion. 

XIV — Outdoor Schools and Medical Treatment for Exceptional 
Children, by Dr. Edward S. Krans, Plainfield, N. J., p. 629. Routine 
of medical treatment. Pedagogical co-operation. Outdoor provisions. 
School routine. Practical conditions. Results from outdoor school 
life. Medical treatment. Ductless glands. Co-operation of medical 
and pedagogic science. 

XV — Ductless Gland Irregularities in Exceptional Children and 
Their Treatment, by Dr. E. Bosworth McCready, Pittsburgh, Pa., 
p. 633. Importance of the ductless glands. Various functions of the 
glands. Ductless-gland irregularity in exceptional children. The 
hypoplastic child. Deformation of the sella turcica. Treatment. 

XVI — The Mentally Backward Child from the Standpoint of the 
Neurologist, by Dr. M. Neustaedter, New York, p. 639. Children 
far below the normal standard. Concomitant factors of backwardness. 
Etiological factors. Amelioration of these conditions. Conclusion. 

XVII — Care of the Neurotic and Psychopathic Child, by Dr. Fred- 
eric J. Farnell, Providence, R. I., p. 645. Infantile roots of adult 
psychopathy. The make-up or personality. Unconscious elements. 
Early repressions. Relations of parent and child. Interpretation of 
misconduct. Method of handling patient. Correction of faulty mental 
habits. 

XVIII — A Brief Statement of the Ttreatment of the Psychopathic 
Personalities Observed in Those Who Develop Dementia Pre- 
cox, by Dr. Howard A. Knox, Ellis Island, N. Y., p. 648. Predementia 
precox. Four types of personality. Influence of adolescence. Causa- 
tion and type. Toxic origin. Prevention of the disease. 

XIX — The Medical Treatment of Exceptional Children, by Dr. 
Tom A. Williams, Washington, D. C, p. 651. Causes of deviation from 
type. Physical causes: the air, incorrect food and drink, inadequate 
or improper exercise, imperfect elimination, disordered glandular ac- 
tion. Pituitary disorder; thyroid disorder; adrenal disorder; thymus 
disorder. Psychopathology : mismanagement of attention, results of 
inattentiveness, hysteria, hysterical anorexia, why a child's mind 
needs work, oversustained attention, overintensity. Mismanage- 
ment of emotion, sentiment, desires, and inclinations; intemperance; 
hysterical phobia; emotions; night terror; shame and anxiety; mul- 
tiple manias; malady of scrupulosity; psychic hardening; shame of 
sex; shyness. Definitions. 

XX — Epilepsy, by Dr. D. C. Main and Miss Sarah Bard, Welaka, Fla., 
p. 677. Extent of the epilepsies. Causes of epilepsy. Treatment of 
epilepsy. Dietetic treatment. Medical treatment. Potential epilepsy. 
Mental condition of epileptics. Possible improvement. 

XXI— Sexual Hygiene, by Dr. Arthur W. Weysse, Boston, Mass., 
p. 681. The r61e of the sexual instinct. Masturbation. Causes of 
masturbation. Sexual education. Sexual abnormality as a cause of 
exceptional development. 

XXII — Some Sexual Abnormalities, by Dr. W. F. Blake-Burke, 
Plainfield, N. J., p. 684. Atypical children and sexual problems. In- 
fantile conditions. Timely training. Constipation. Other irritations. 



xxvi CONTENTS 

XXIII — Treatment of Juvenile Delinquents, by Dr. j'ohn Adams 
Colliver, Los Angeles, Cal.,* p. 687. A medico-socio-psychological 
problem. Etiology. Pathology; perversion. Irritability as an initial 
symptom. Local causes of irritation. Other curative measures. 
Psychological. 

XXIV — Inherent Immorality, by Dr. Ross Moore, Los Angeles, 
Cal., p. 692. Heredity vs. free-will. Types of character. The in- 
herently immoral. Varieties and forms of non-altruism. Anomaly of 
character. Two distinct types. Type first: the immoral from impul- 
siveness. Type second: the immoral from deficiency of sympathy. 
Diagnostic elements. Treatment. 

XXV — The Promise of Research in the Anatomy of Feeble- 
mindedness, by Dr. E. E. Southard, Boston, Mass., p. 698. The 
anatomy and pathology of feeble-mindedness. Individual problems. 
The personal attitude. Mental tests. Blood tests. Somatic and 
sociological elements. Brain anatomy in the feeble-minded. Corre- 
lation of findings. Application to the normal. 



PACE 



Appendix III — First and Second Year Data of P. 
E. G 707 

Appendix IV — Specimens of Reports on Children 
Examined 712 

Appendix V — Bibliography of Some of the Books, 
Pamphlets, and Articles Consulted in the 
Preparation of this Book or Suggested for 
Collateral Reading 719 

LIST OF CASES 

1. Johann Heinrich Pestalozzi, p. 25. 

2. Johann Kepler, p. 25. 

3. Emiliano Zapata, p. 45. 

4. Daniel Webster, p. 92. 

5. Henry Ward Beecher, p. 92. 

6. Friedrich Frobel, p. 92. 

7. Carl von Linnaeus, p. 92. 

8. Alessandro Volta, p. 92. 

9. Robert Burns, p. 92. 

10. Honore Balzac, p. 92. 

11. Thomas Edison, p. 92. 

12. Walter Scott, p. 92. 

* Just before this book goes to press, the death of this distinguished 
physician is reported. 



CONTENTS 

Charles Darwin, p. 92. 

John Stuart Mill, p. 92. 

Herbert Spencer, p. 92. 

Helen Keller, p. 98. 

Robert Wiener, p. 108. 

Winifred Sackville Stoner, Jr., pp. 108 jj. 

W. S., boy, s l A years, p. 113. 

P. E. G., boy, 2 years n months, pp. 115 jf., 707 ff. 

Michael Angelo, pp. 119, 127. 

Friedrich Riickert, p. 119. 

Henry Wadsworth Longfellow, p. 119. 

James Clarence Mangan, p. 119. 

W. B., boy, 16 years, p. 120. 

H. H., boy, 13 years, p. 120. 

Ulysses S. Grant, p. 121. 

Jacques Inaudi, p. 123. 

Idiot, mathematical prodigy, p. 123. 

Tredgold's feeble-minded man, p. 124. 

Otto Pohler, pp. 125/. 

Wolfgang Amadeus Mozart, p. 127. 

Franz Joseph Haydn, p. 127. 

Ludwig van Beethoven, p. 127. 

John Milton, p. 127. 

Johann Wolfgang Goethe, pp. 127, 281. 

Francois Marie A. de Voltaire, p. 128. 

Isaac Newton, p. 128. 

Karl Friedrich Gauss, p. 128. 

William James Sidis, pp. 128 Jf., 132. 

W. B., boy, 9 years, pp. 130/. 

A. S., boy, 14 years, pp. 131, 151. 

H. H., girl, 14 years, pp. 131, 151/. 

N., boy, pp. 145/. 

M., boy, pp. 145/. 

R., boy, pp. 145/. 

Farnell's boy, 12 years, p. 155. 

FarnelPs girl, 16 years, p. 156. 

Williams's girl, 8 years, p. 157. 

Williams's girl, p. 157. 

Williams's boy, 14 years, p. 157. 



xxviii CONTENTS 

52. K. B., boy, 14 years, p. 157. 

53. Charles Lamb, p. 158. 

54. Napoleon I, pp. 186, 199. 

55. George Washington, p. 186. 

56. Louise, 18 years, p. 202. 

57. Newspaper boy, 5 years, p. 202. 

58. E. S., boy (colored), 9 years 9 months, p. 224. 

59. X. A., boy, 14 years, p. 224. 

60. F. C, boy, 15 years, p. 242. 

61. J. F., boy, 16 years, p. 242. 

62. G. S., boy, 15 years, p. 243. 

63. R. F., boy, 17 years, p. 244. 

64. L. D., boy, 17 y 2 years, p. 245. 

65. D. T., boy, 20 years, pp. 246, 586. 

66. Boy, p. 305. 

67. Armando, p. 317. 

68. Boston boy, 12 years, p. 341. 

69. Edgerton boy, 12 years, p. 342. 

70. Boston girl, 13 years, p. 342. 

71. Boston girl, 11 years, p. 343. 

72. Boston girl, 10 years, p. 344. 

73. Miss Haskell's girl, p. 432. 

74. Kindergarten boy, A., p. 463. 

75. Kindergarten boy, M., p. 463. 

76. Kathryne Frick, p. 503. 

77. C. G., male, 26 years, p. 585. 

78. D. L., boy, 14 years, p. 587. 

79. E. K., girl, 14 years, p. 587. 

80. H. H., girl, 9 years, p. 588. 

81. M. A., boy, 14 years, p. 589. 

82. Williams's girl, n years, p. 656. 

83. Williams's girl, n years, p. 659. 

84. Williams's boy, n years, p. 664. 

85. Woman, "gnawing fox" case, p. 667. 

86. Williams's girl, p. 667. 

87. Williams's boy, 8 years, p. 668. 

88. Williams's boy, 3 ^4 years, p. 669. 

89. Williams's girl, 16 years, p. 669. 

90. Williams's boy, 14 years, p. 672. 



CONTENTS xxix 



91. Williams's case, male, 30 years, p. 673. 

92. M. P. E. G.'s girl, 10 years, p. 682. 

93. Boy, 5 years 10 months, p. 683. 

94. Boy, 14 years, p. 712. 

95. F. G., boy, 7^ years, p. 713. 

96. A. W., girl, 10 years, p. 714. 

97. D. B., girl, 13 years, p. 714. 

98. W. B., boy, xz}4 years, p. 715. 

99. R. B., girl, 13 years, p. 715. 

100. T. B., boy, 103^ years, p. 716. 

101. J. U., boy, 13 years, p. 716. 

102. R. U., boy, 11 years, p. 717. 

103. J. E. C, boy, 7 years, p. 717. 

104. B. C, boy, 11 years, p. 718. 



ILLUSTRATIONS 



FIG. 



i. Percentage diagram of exceptional children 8 

2. Diagram of social strata 64 

3. Winifred Sackville Stoner, Jr., in eurhythmic pose 

Facing page 108 

4. P. E. G., making believe he is taking a photograph 

Facing page 116 

5. P. E. G., in his "barn" Facing page 116 

6. Sketch from life by A. S Facing page 130 

7. Sketch from life by H. H Facing page 130 

8. Water-color sketch by A. S Facing page 132 

9. Outdoor sketch by H. H Facing page 132 

10. Lichtenheim speech schema 147 

11. Educational clinic of the National Association for the 

Study and Education of Exceptional Children, 

Plainfield, N. J Facing page 270 

12. Educational clinic, " Her bart Hall." . . Facing page 270 

13. Doctor Reber's kindergarten chart 297 

14. McCallie's illiterate vision test 299 

15. The Knox Cube Test 319 

16. The one hundred A's test. Test in concentration . . 323 

17. Cipher of the third order 332 

18. Boston Graph Chart I 341 



xxxii ILLUSTRATIONS 

FIG. PAGE 

19. Boston Graph Chart II 342 

20. " " "III 342 

«■ " " "IV 343 

"V 344 

23. Healy form board No. 3 Facing page 350 

24. Healy puzzle No. 5 (pictorial completion test) .... 352 

25. Anchor puzzle 355 

26. Field of search — one hundred dots 356 

27. Educational Clinic: building of houses, steps, bridge, 

etc Facing page 358 

28. Ancient Egyptian painting: pond with trees 361 

29. Child's drawing of pond with trees: radical arrangement 

of trees 361 

30. Ancient Egyptian painting: brickmakers 362 

31. Indian drawing of a shaman's lodge 362 

32. Child's drawing of pond with trees in symbolical arrange- 

ment 363 

23- Indian drawing of medicine-lodge 363 

34. Rectangular pond with trees on opposite sides. Child's 

drawing. Trees in perspective . . . Facing page 364 

35. Free-hand drawing by K. B Facing page 364 

36. Arbitrary diagram of endowments 369 

37. Main court-room, Children's Court, New York 

Facing page 386 

38. Small court-room, Children's Court, New York. Judge 

Hoyt sitting in "The Heart of the Children's Court" 

Facing page 386 



ILLUSTRATIONS xxxm 

FIG. p AGE 

39. May festival Facing page 506 

40. Blue-print design from nature: Ferns . . Facing page 516 

41. Blue-print design from nature: Violets . Facing page 516 

42. Exhibit of pupils' work. Carpentry, basketry, dressmak- 

ing, weaving, etc Facing page 518 

43. Exhibit of pupils' work. Miscellaneous . Facing page 518 

44. Sandnable work. The lake-dwellers . . . Facing page 520 

45. Pupils' work. Vocational Training School. Building a 

house with concrete foundation . . . Facing page 520 

46. Dramatics: Scene from "The Sleeping Beauty" 

Facing page 530 

47. Dramatics: Dance of the ice-bears. From "A Dream- 

Trip to Northern Lands " Facing page 530 

48 to 54. Casts of teeth Facing page 586 

55 to 62. Casts of teeth Facing page 588 

63. Judge Wilbur's graphic cards 691 



PART I 

THE PROBLEM OF THE INDIVIDUAL 
CHILD 

CHAPTER I 

THE EDUCATIONAL PROBLEM IN GENERAL 

The Public School and Its Critics. — America's greatest 
pride has always been its public school system. The 
American public school is the expression of democracy in 
education. It differs in its democratic organization from 
the school systems of other countries, pedagogic Ger- 
many included, where the public elementary school is 
only for the " masses," and where other kinds of schools 
exist for the "classes." 

However, for the last few decades the public school, 
even in this country, has in many instances been de- 
serted by the children of the "classes." For them a 
number of private and "finishing" schools have sprung 
up. This development has one cause in the change of 
social conditions and standards in the commonwealth. 
Another cause is an increasing distrust in the efficiency 
of public education. 

Of late years a great outcry has been raised against 
the public schools. The question is asked in many quar- 
ters: "What is the final value of our school system?" 
Criticism is voiced against conditions of immediate con- 

1 



2 THE EXCEPTIONAL CHILD 

cern, such as efficiency in administration, efficiency in 
the methods of teaching, efficiency in giving the indi- 
vidual child a "square deal." But far broader and more 
serious considerations are causing an ever-louder voice 
of protest. 

Generation after generation of native-born citizens 
have been laying the foundation for an American people 
as a distinctive national unit. This new people, how- 
ever, lacks racial uniformity. In creating a new nation 
out of the mixed blood from the Old World, America 
has a gigantic task before it. Race characters of divers 
kinds must be blended into a new national type which is 
really international in essence. In this process the main 
problem consists in preserving and conserving the pro- 
gressive and constructive elements of each racial and 
national constituent, and in eliminating the backward 
and antisocial elements as far as possible. These in- 
clude physical characteristics, weaknesses and advan- 
tages, as carried and developed through the centuries; 
and mental, emotional, and ethical factors and differ- 
ences as well. 

With the development of industries and commerce, 
broader national interests and aspirations are being 
recognized by the individual citizens. Questions of na- 
tional policy within and without the country, the rela- 
tions of groups of citizens to one another, and of the 
nation to other nations, are occupying the minds of 
thinking men and women. 

A national consciousness is awakening. 

Thus the question arises: "What are the public schools 
doing, not only to conserve the nation's young, but to 
prepare them for efficient citizenship under a democratic 
government which will permit progressive solidarity of 



THE EDUCATIONAL PROBLEM IN GENERAL 3 

individual interests and a clear-cut national policy 
toward the world?" Many, and oftentimes appalling, 
are the failures in life, despite public school training. 
Many and undeniable are the evils of our national life. 
Both the individual and the national failures are being 
laid at the doors of the schools which are accused of 
wrong ideals and practices. 

Much of this denunciation is exaggerated and unfair. 
We are apt to overstate our grievances. But we must 
not blind ourselves to the fact that there is a great need 
of new educational standards, aims, and ideals. Let us 
look into the situation more closely. 

In considering the efficiency of our whole public edu- 
cational system it may be well to pause a moment and 
to think of its fundamental objects. For what is edu- 
cation expected to prepare the nation? What should 
education do for the welfare and progress of the com- 
munity? What is it to do for the child as an indi- 
vidual ? 

Education and National Ideals. — It is not the purpose 
of this book to dwell more than in passing upon the re- 
lation of public school education to national aims. It is 
well, however, to call attention to the fact that one of 
the primary functions of education is to supply the 
moral force of progress. 

When we stop to consider that our schools to-day teach 
even their own country's history so superficially that 
the pupils scarcely know, much less understand, the be- 
ginnings and motives of American political, ethical, and 
spiritual evolution and their relation to present-day con- 
ditions at home, what can we expect of the citizen of the 
future when he is called upon to deal with world prob- 
lems ? Of what value to him is the costly experience of 



4 THE EXCEPTIONAL CHILD 

his forebears? How can his moral judgment afford to 
ignore this intellectual background ? How many of the 
pupils of to-day are taught definite ideals for the nation, 
definite in the sense that each voter will help mould a 
national policy which shall be the outgrowth of an im- 
proved democratic form of government based on his- 
torical influences? Without this knowledge of histor- 
ical forces at home and abroad, past and present, is 
not the voter of to-day incapable of intelligent deci- 
sions, and is not the nation's policy largely the result 
of experiment, and determined by the genius of a few 
leading minds? 

This is a day of commercial and industrial supremacy, 
and such an era brings with it tremendous national 
problems. How does the school help the individual 
consciousness to understand the mighty tendencies of 
to-day: the concentration of wealth, the organization of 
labor, etc.? How does it prepare the future citizen to 
deal with the perplexing difficulties of correction and 
relief among the unfortunate; and with that host of 
political and social issues, such as prohibition, taxation, 
direct voting, etc. ? Every one of these problems is the 
result of a growth the germ of which dates back to the 
very foundation of our republic. 

The demand that public school education must in the 
future take the large national issues under consideration, 
and shape its instruction accordingly, may seem star- 
tling, but it is a problem which the older countries have 
long since tried to solve, each in its own way. From a 
conglomerate mass of races and peoples which have set- 
tled in this continent, there must arise a real nation, not 
necessarily homogeneous in stock, but harmonious in 
aim and spirit. National consciousness, national ideals 



THE EDUCATIONAL PROBLEM IN GENERAL 5 

must arise, and these must be awakened in the future 
citizen while he is at school. 1 

Public School Education and Community Problems. 
—The industrial world has long since learned that in the 
process of converting raw material into a finished prod- 
uct, waste must be reduced to a minimum. The older 
extensive methods of production are giving way to 
highly scientific, intensive forms. Instead of fashioning 
but one kind of finished product, many kinds are now 
developed from the same raw material. 

We are beginning to discover that one of the most 
important raw materials, namely, the human material, 
is being most wastefully treated. For the sake of ob- 
taining a single article, complacently called the " aver- 
age" man or woman, we are throwing immense quanti- 
ties of unexploited material on the human scrap-heap. 
The business of life is not primarily the attainment of 
commercial, industrial, or scholastic success. // repre- 
sents fundamentally the age-long effort to develop the race, 
that is to say, the men and women of the community, 
to a higher level of human intercourse and moral relation. 
As a matter of fact, commerce, industry, and all other 
outward forms of progress, while spelling the tangible 
elements of success, are not in themselves the goal. 
They are the handmaids of community development 

1 " Great, progressive races are mixed races. Consider the ancient 
Romans and the early English ! The original Celts of the British Isles 
were driven back before the Romans and the barbarian tribes, but the 
later fusion of Celtic, Norse, Anglo-Saxon, Jute, and Norman elements 
has swept the seas with its mighty fleets and has conquered large spaces 
of the earth with its sturdy armies. . . . And within our domain prog- 
ress and growth have followed the route of the pioneer and the immi- 
grant. Progress has been slowest to develop in those sections where 
the blood of the people has remained least mixed." — Armour Caldwell 
in The American Leader, May 27, 191 5. 



6 THE EXCEPTIONAL CHILD 

along the lines of higher civilization and culture. From 
this it follows that education must never lose sight of 
those fundamental purposes of national growth. To 
prepare children on the principle of narrow utilitarianism 
for personal success within selfish limits defeats the very 
objects of education as community-serving, and from the 
point of view of national and world progress. 

As in the conversion of crude oil into petroleum it 
was found that the by-products (naphtha, aniline dyes, 
mineral oils, medicines, etc.) outvalue the first product, 
so by an analogous process we are beginning to find that 
the by-products of the raw human material, represented 
by the many individual variations, are far more valuable 
than the "average" person. 

It costs the citizens of the United States $1,100,000,000 
each year for police, courts of justice, prisons, charities 
and correction, and similar forms of self-protection 
against the festering human refuse-heap. A continued 
or even increasing annual outlay of such an amount 
under the heading of "losses" on the debit side of the 
ledger spells ruin for the nation. It indicates the pres- 
ence of a highly dangerous social cancer, one of a most 
malignant and progressive nature, one whose treatment 
is most costly in cold terms of money. 

The Business of Life needs to be placed on the basis of 
efficiency. The saving is not merely one of money but, 
what is vastly more important, one of human souls. 
Life's enterprise must be conducted like any other busi- 
ness. New methods to avoid, to reduce, and to convert 
waste must be found. Capital must be invested in 
human assets. 

It is a curious fact that the nation is spending only 
$600,000,000 annually for schools, churches, and other 



THE EDUCATIONAL PROBLEM IN GENERAL 7 

constructive agencies; in other words, $500,000,000 less 
is spent to develop human assets than is spent to keep 
up the human failures! 1 It would seem reasonable to 
expect the American people to apply their recognized 
business perspicuity to invert these figures, investing 
more for constructive conversion and conservation. Such 
investment in proper methods of conversion of waste 
would reduce the enormous refuse-heap now accumulat- 
ing in the form of human derelicts, causing it automati- 
cally to shrink to reasonable bounds. 

All the failures in the Business of Life, among them the 
500,000 or so of criminals "doing time" in the prisons 
of this land, were once pupils in our schools, or play- 
fellows in our city streets, in the villages, and the rural 
districts. 

The salvation of these human derelicts is a social 
problem. Better methods of conversion must still be 
studied and applied. The problems of the future can 
be solved only when, first, we recognize existing ccndi- 
tions, and, second, apply the remedy intelligently. Here 
is an educational problem in the widest sense of this 
term. 

The productive power created by right education re- 
leases social and economic values many times in excess 
of the capital invested. The aggregate of human fail- 
ures which have to be kept under control by the expen- 
diture of enormous sums, represents a dynamic force of 
stupendous magnitude. It can and must be converted 

1 Mr. Edward Morrell, the San Quentin convict, who has been helping 
Warden Thomas Mott Osborn to put Sing Sing under the honor system 
of self-government, gave, in an interview in the Evening Mail (New 
York) of May 19, 1915, much higher figures. He says: "This country 
is spending annually $3,500,000,000 to support its criminal institutions. 
This is half again as much as goes for training in schools and colleges." 



THE EXCEPTIONAL CHILD 



100* 



m 



y^* - • 


%/ 


*.v:'-'?r-?.".''''''-''T\ 




&*ljj 






v </ 



Fig. i. 
Percentage diagram of exceptional children. 

The circle represents the entire number of children of school age in the United 
States. 

The white quadrant indicates the estimated proportion of perfectly healthy, nor- 
mal children. All the others are more or less handicapped and in danger. 

The dotted semicircle (e) indicates the pseudoalypical children who are laboring 
under some removable disadvantage — scholastic, physical, and otherwise. 

The shaded quadrant includes various groups of truly exceptional children. 

(a) Abnormal children (2 per cent) ; 

(b) Subnormal children (5 per cent) ; 

(c) and (d) Atypical children (18 per cent); 

(d) Exceptionally bright children (3 per cent). 

Presented in figures, the problem would appear as follows: 

Number of children of school age 24,000,000 

Some investigators claim that 90 per cent have some defect or ailment 2 1,600,000 
More conservative estimates restrict this to only 75 per cent 18,000,000 

This would leave only 25 per cent (6,000,000) healthy, normal 

children. Among the 75 per cent of handicapped children are 

the following: 
Pseudoalypical children — about 50 per cent _. ... 12,000,000 

Those who suffer from easily removable difficulties, including 

physical ailments. 
Atypical children — about 18 per cent 4,320,000 

Including the exceptionally bright, the nervous, the difficult, the 

retarded child. 
Subnormal children — about 5 per cent 1,200,000 

Including the blind, deaf, crippled, arrested, economically sub- 
merged, and primitive groups. 
Abnormal children — about 2 per cent # 480,000 

Including the moral perverts and imbeciles, the feeble-minded, 

insane, etc. 1 
1 The figures presented in this chapter have been compiled from a large number of 
sources, medical reports, special investigations, etc., and are conservative. 



THE EDUCATIONAL PROBLEM IN GENERAL 9 

into a helpful, constructive force instead of being a 
menace to society. 

The Human Raw Material. — The human raw material 
is to-day in the form of 24,000,000 children of school 
age (5 to 18 years). Just as a chemist analyzes rock 
or ore, so this material can be divided into its compo- 
nent parts. The diagram on page 8 represents graphi- 
cally the problem of the child as outlined in the classi- 
fication and terminology employed in this book. (Cf. 
Chapter IV.) 

Any one of these truly exceptional children, including 
the exceptionally bright, the "different," the neurotic, 
the retarded, the subnormal, and the abnormal children, 
is a potential derelict, failure, crank, or criminal. Sav- 
ing him depends upon timely care and training. 

Even the pseudoatypical child will go wrong through 
neglect. 

Of the physical ailments alluded to, these figures will 
show their appalling extent: 

50 to 75 per cent of all children suffer 
from defective teeth (with all the 
consequences resulting therefrom) 12,000,000 to 18,000,000 

30 per cent suffer from nasal obstruc- 
tions 7,200,000 

26 per cent suffer from eye-strain 1 .... 6,240,000 

20 to 25 per cent suffer from nervous 

disorders 4,800,000 to 6,000,000 

12 per cent suffer from some deformity 2,880,000 
4 per cent suffer from defective hear- 
ing 960,000 

2yi per cent suffer from tuberculosis. . 600,000 

1 Doctor Lewis C. Wessels, ophthalmologist of the Bureau of Health, 
Philadelphia, published an investigation of visual defects in school chil- 
dren of his city in School Progress of May, 1915. He writes: "As a rule, 
the position in class was in direct ratio to the visual defect, the worse 



10 THE EXCEPTIONAL CHILD 

It will be readily noted that we have in this raw ma- 
terial the makings of all the cankers and sores of our 
body social, and that it is the problem of education to 
convert the human failures into human assets, reducing 
the final waste to an irreducible minimum. 

The Public School and the Child. — In the preceding 
sections we have discussed education as a national and 
community policy. When we deal with education in its 
relation to the individual child we come to a more direct 
problem. What shall education mean to the child as an 
individual ? This is a question which can be variously 
answered, and its answer is the real object of this book. 
That it cannot be dismissed with a simple definition 
covering all children equally, the author hopes to make 
apparent as he proceeds. Before entering upon a more 
detailed discussion of the various phases of the problem 
the author will briefly consider a few of the criticisms 
directed against the present form of public school edu- 
cation. 

These criticisms usually fall under two heads: those 
dealing with administrative problems and those dealing 
with education as such. 

Administrative Problems. — The American public 
school has of late years become a huge and unwieldy 
piece of machinery. The diffused population of former 
years has been drifting more and more to limited areas. 
Our cities have grown by leaps and bounds, and we have 
before us the problems of urban congestion. Great 
waves of migration would roll along the nation's high- 

the defect the more backward the pupil. The worst cases were natu- 
rally sent to the dispensary first in 1908. Seventy-six per cent of those 
pupils were backward. In 1914 the serious defects were not so numer- 
ous, yet 62 per cent were backward. The average for seven years was 
67 per cent retarded children, principally on account of defective vision." 



THE EDUCATIONAL PROBLEM IN GENERAL 11 

ways in unexpected directions and would create new 
centres of density and accumulation. Even in the rural 
districts, the tendency of school administration has been 
to combine the scattered small schools into fewer, but 
larger, more centralized buildings. Added to this inter- 
nal shifting of the population there has been a tremendous 
influx of great masses through foreign immigration. Be- 
fore the plans to build and equip schoolhouses, to pro- 
vide teachers, administrative officers, and the manifold 
material needs for the millions at a given time have been 
put well under way, and long before completion of these 
plans, still greater demands are thrust upon the authori- 
ties. As a result, the educational machinery has in 
most cases been inadequate for current demands. 

Superintendents of schools and boards of education 
have been so absorbed in these administrative problems, 
building and equipping schoolhouses, training teachers, 
selecting and providing school and other material, etc., 
that these demands have deprived them of time for 
concentrated thought upon educational problems as 
such. 

As a matter of administrative expediency the pupils 
have been placed in large groups in palatial school-build- 
ings, often housing one thousand or more; these groups 
being subdivided into classes varying in attendance 
anywhere from thirty to sixty pupils. It has become a 
question not of training each pupil to his highest effi- 
ciency, 1 but of pushing the greatest number ahead with 
a minimum of progress compatible with a grade. Effi- 
ciency is being measured by classes, not by pupil units. 
Individual differences, aptitudes, and difficulties are per- 
force lost to sight. Extensive rather than intensive 

1 See Chapter II. 



12 THE EXCEPTIONAL CHILD 

administrative methods have become the vogue. This 
naturally means wasteful production, the very opposite 
of all modern tendencies. 

About 20 per cent of all pupils in our schools are "re- 
peaters." That is, they repeat one or more grades dur- 
ing their school career, failing of promotion. This illus- 
trates, among other things, the costliness of our present 
methods, as the following table will show: 

The average cost for each pupil per annum is about $40 
In a city with a school population of 100,000 the tax- 
payers must annually provide approximately. . . 4,000,000 
20 per cent repeaters (20,000) cost for one year. . . . 800,000 
At least one-half of this number could have been 
saved from repeating by adequate medical relief, 
differentiated instructional provisions, and bet- 
ter teaching; therefore wasted expense 400,000 

We may find that most of the repeaters might have 
been saved the loss of time and expense; thus the waste 
is still more appalling. 

It can be shown in other ways that the administrative 
problems are still far from being solved. These difficul- 
ties are reflected in the education as such and give rise 
to the multitude of individual problems which agitate 
the home and, in their aggregate, the nation. 

Education and the Individual Pupil. — Education, pure 
and simple, is never a problem of masses; it is forever 
that of the individual child. In the family, in the small 
school of bygone times, even in the ungraded rural 
schools — whatever imperfections these educational in- 
stitutions may have had — the individual child has had 
a greater chance for recognition and special treatment 
than he has in the school palaces of our great cities. 

The present school system is built largely upon a fal- 



THE EDUCATIONAL PROBLEM IN GENERAL 13 

lacious application of the declaration of political inde- 
pendence in which all men are declared equal. Socially 
this should mean that all men must be given an equal 
opportunity. But in the matter of endowments, of apti- 
tudes, of fitness for life's work, all of us are very unequal, 
representing different types varying widely in character 
and intensity. Even with equal or similar endowments, 
there is a difference of individual rhythm. The rate of 
physical growth and of functional development, includ- 
ing the mental, differs greatly in different individuals, 
so that it appears unfair to expect the slow to run a race 
with the quick. 

Individual differences have, of course, been recognized 
in a vague way at all times. Striking differences natu- 
rally attracted attention and received first considera- 
tion when it came to making provisions for differentia- 
tion in teaching. During the early and prescientific 
observation of school children, one of the first groups 
to emerge for special care, as being an exception to the 
rule, was that of meagre endowments. But this differ- 
entiation even to-day remains quite crude. Many a 
child who is simply tardy in his mental and physical 
growth is thought dull or mentally defective, although 
in reality oftentimes possessed of unusual mental vigor; 
and the child of circumscribed ability is confused with 
the child of feeble and abnormal mind. Of late years 
scientific methods of research are penetrating more 
deeply into the child problems and permit clearer dis- 
tinctions. 

It is perfectly true that there is a larger number of 
truly mentally defective persons than has been suspected 
{cf. figures given before), and that they represent a dis- 
tinct burden on society. It is imperative that the 



14 THE EXCEPTIONAL CHILD 

problem of the really abnormal be faced and be handled 
intelligently. Among our criminals, our paupers, our 
prostitutes, and all those who are generally ineffective 
and unable to become socialized, there is a small percent- 
age of mentally abnormal types — types that are, as far as 
we know, unredeemable. 

This group, representing irreducible waste, does not, 
however, constitute primarily a school problem. It con- 
stitutes an economic problem, a social problem, a psycho- 
pathic problem, a medical problem. The group includes 
two distinct types: the feeble-minded and the insane. 
It postulates opportunities for custodial care. 

But the burden of criminality , ineffectiveness, and failure 
in life cannot be laid upon mental defect in the majority of 
cases. Many a well-endowed person has failed in life 
because he did not have the training which would have 
fitted him to do his best; or because adverse social and 
economic conditions in an unfavorable environment pre- 
vented him from living the life for which Providence had 
endowed him; or because in some other way he had 
missed his true vocation. Economic pressure has in- 
creased among the pariahs of society; and the most 
common disease of our captains of industry is neuras- 
thenia, not to say psychasthenia. In a measure, we are 
dealing with misdirected potentials of leadership in the 
ranks of capital as well as of labor. 

Many a criminal of the type which is reached by law 
is mentally brilliant. We must not underestimate the 
moral qualities even of the "underworld." There is a 
spirit of "gang-fairness," a singular sense of responsi- 
bility for one another. There are even sentiments and 
circumscribed virtues to be found among the unfortu- 
nates who live in the seething caldron of crime and 



THE EDUCATIONAL PROBLEM IN GENERAL 15 

immorality beneath our very feet. Here again we are 
dealing with misdirected potentials. What have become 
destructive tendencies might have been led into construc- 
tive channels if the individual possibilities and needs of 
these outcasts had been understood when they were chil- 
dren. 

It is an interesting but not generally known fact that 
against the estimated 2 per cent of mentally abnormal 
children, those at the lower end of the line, we have at 
least equally as many at the upper end. These are the 
unusually bright and promising — those who are destined 
to become leaders of thought and action. The excep- 
tionally fit have so far received less attention than the ex- 
ceptionally unfit. Yet, oftentimes one who might have 
been trained to become a leader for good, for progress, 
and for the highest ideals of the nation and of humanity, 
is so warped by neglect and lack of constructive oppor- 
tunity that he becomes the misleader, the demagogue, 
the oppressor, the shark, the destroyer, the crank. 

Between these two ends there are hundreds of varie- 
ties of attitude, of aptitude, of physical and mental en- 
dowment, or of moral and emotional quality. There 
are so many different types of mind, all approaching their 
own life problems from a different angle, be it that of 
the artist and dreamer, that of the constructive genius, 
or that of the commercial organizer, of the master of 
the word and of abstract thought : that it is appalling 
to think that we have attempted to cast them all into 
the same mill of school education, expecting to see each 
type emerge from the spout at the other end unmixed 
and unpolluted, perfect and well-ground in its own right. 

So wasteful has the extensive method of education be- 
come in the effects produced on the community that the 



16 THE EXCEPTIONAL CHILD 

public is seriously alarmed by what seems a new prob- 
lem — the exceptional child. Criticisms of existing meth- 
ods are rampant among educators and thinking men 
and women; alarm is being expressed by the laity over 
the increase of ineffectiveness and of variants from the 
"average." The thinkers are seeking to find definite 
causes and to remedy conditions; the laity are allowing 
themselves to be aroused and misled by startling state- 
ments and quack remedies. 

The Problem of the Exceptional Child. — Thus, the 
problem of the exceptional child constitutes a vital issue 
in modern education. It means, first of all, changing 
from our extensive methods to those which are inten- 
sive. A real solution must go to the very roots of edu- 
cational principles and practices. In a narrower sense, 
the exceptional child is the moving power of our civiliza- 
tion. "Average" man — the man of mediocrity — rep- 
resents a stable, stale, stagnant element — the "mass." 
But the exceptionally bright child, the child of so indi- 
vidual a mind that he defies average standards, one who 
wants to go his own way self-directed; yes, even the slow 
child who gathers his characteristic strength little by 
little, like a slow-growing oak which outlives centuries, 
he is the one who moulds the destiny of our race, and his 
powers may be turned into evil as well as into good, in 
proportion to the stimulus toward right motives he re- 
ceives at the turning-points of his life. Truly, the "va- 
riation from type" is a factor in the development of the 
race. 

Even the really backward child is more needy of 
attention than the "average" child. The latter will 
usually find his way in this humdrum Philistine world 
of ours, and will represent "average" virtue and "aver- 



THE EDUCATIONAL PROBLEM IN GENERAL 17 

age" standards without much effort or danger. But the 
child whose powers, while normal, are weak, needs much 
help to find his place and to do his work in life. 

In considering the various forms of child life, it will 
become evident that education must mean something 
different to each one if it is to speak a known language 
to him. The special purpose of this book is to lay stress 
upon the right differentiation of children as to type and 
condition, and to concentrate attention more particu- 
larly upon the needs of those who require individual 
recognition and training. It suggests methods by which 
the problem can be studied and by which much of the 
human waste can be reclaimed. Modern methods of 
conservation and improvement of the race are needed 
to reclaim the handicapped normal child. A scientific 
analysis must naturally precede the process of reclama- 
tion. Then it will be possible to reduce the present 
waste to the irreducible residue, and to convert what 
can be reclaimed into valuable assets for our civilization. 
This analysis is here attempted. 



CHAPTER II 

THE PROBLEM OF EFFICIENCY 

Standards of Efficiency. — In a discussion of educa- 
tional methods and of problems of individual adapta- 
tion, so that each child may grow up to do his social 
service in his own best way, the problem of efficiency 
demands serious consideration. 

In the valuation of this problem we must, however, 
come to a clear understanding as to the meaning of the 
term "efficiency." Much attention has recently been 
given to "standards of efficiency" in business, in teach- 
ing, in government, and what not. We have "efficiency 
experts," "efficiency tests," and a host of suggestions as 
to how to attain "efficiency." Each author has an in- 
terpretation of the term "efficiency" peculiarly his own, 
often entirely at variance with the previously formed 
conceptions of the reader. 

This book is not intended to offer a treatise on the 
psychology of the subject. The author will attempt, for 
practical purposes, in a common-sense sort of way, to 
distinguish between efficiency, as he understands the 
term, and skill, so as to show the significance of differen- 
tiating between the two when dealing with educational 
problems. 

Efficiency vs. Skill. — Efficiency is the ability of the 
individual to appreciate his environment in its various 
phases, to recognize the material and spiritual oppor- 
tunities for social betterment which it contains, and to 
project upon it his own best self for the progress of the 

18 



THE PROBLEM OF EFFICIENCY 19 

commonwealth. Efficiency finds its highest expression 
when it produces a reciprocal relation between the best 
in the individual and the best that is to be found in the 
outside world — a relationship of mutual uplift. There- 
fore, it has essentially intellectual, moral, and spiritual 
qualities. It enables the individual not only to compre- 
hend, in the broadest sense of this term, but to construct, 
to create, as well. It implies potential ability along 
many different lines of activity. 

Efficiency is the quality of the leader. It does not 
confine itself to opportunities for doing big things, nor 
does leadership restrict itself to exalted places. It really 
manifests itself in the faculty of doing all things well — 
the small as well as the big; and in the power of adjust- 
ing oneself quickly and intelligently to changing condi- 
tions and new problems. To be efficient has always 
been the distinction of the complete normal man. 

Individual Competency. — Each individual possesses a 
distinct combination of physical, mental, emotional, 
spiritual, and other endowments. These particular en- 
dowments, latent and unrecognized as they may be, 
represent his potential competency. There is seldom an 
individual so poor in endowments of some kind that he 
could not develop actual competency of considerable 
strength if he had a suitable field for their conservation, 
cultivation, and exercise. These endowments are influ- 
enced in a great measure by hereditary factors and by 
the type of community in which the individual grows 
up. They are affected by the standards of material 
progress, of public spirit, of morality, etc., which pervade 
his social environment. 

Individual Increment. — In a progressive community 
the life of each individual should represent some form of 



20 THE EXCEPTIONAL CHILD 

increment to that progress. But the full competency 
latent within each one is aroused, developed, and directed 
to a high state of action only in a relatively small num- 
ber of instances. 1 Only a few citizens succeed in pro- 
ducing large individual increments. In the majority of 
cases, competency is only partially or slightly cultivated; 
the resulting individual increments are small — even 
negative, in some instances. 

Types of Men and Mind. — The distinct combination 
of endowments of an individual will tend to direct his 
competency into some particular path. Thus we com- 
monly speak of "types" of men and of mind, meaning 
thereby different physical and mental combinations. 
The competency of the individual will determine the 
"type" of his community increment. The butcher and 
the surgeon, the apothecary and the chemical research 
professor, the soldier and his general, the clerk and his 
employer — each one will add his increment to the prog- 
ress of the community in terms of his own competency. 

But there is a great difference in the performance level 
of each. The butcher may develop into a splendid sur- 
geon, the apothecary into a successful research chemist, 
etc., by improving his performance level. Such a higher 
level can be reached mainly through a more intensive 
intellectual training. Intellectual quality cannot be al- 
tered in any single generation; training will not increase 
the ultimate limits of individual mental endowments. 
But training can co-ordinate, educate, and elevate the latent 
abilities to their highest performance level. It is this de- 

1 That there are in every man vast numbers of unused potentials is 
illustrated by the fact that only a fraction of the actual number of brain 
cells is really functioning. "The wisest person that ever lived probably 
had several million brain cells that were more or less idle." — Halleck. 



THE PROBLEM OF EFFICIENCY 21 

velopment of the intellectual quality in quantitative 
measure which generates, as it were, the dynamic value 
of the individual's endowments and increases his incre- 
ment to community progress. 

Complexity of Modern Life Conditions. — Under pres- 
ent life conditions it is far more difficult to leave our 
individual imprint, in terms of efficiency, upon the com- 
munity than at any previous time. To appreciate fully 
the various phases of even the simplest present-day en- 
vironment is an infinitely more complex matter than it 
was a hundred years ago, especially in cities and in the 
more thickly populated sections of the country. In the 
past, most people found the groove along which they 
could work efficiently with relative ease. Changes 
came slowly, so that there was time for readjustment. 
Social strata, classes, and castes existed for centuries, 
distinct and limited in their ambitions and activities. 
Within the limits of their life conditions there was much 
opportunity for the individual to do whole-hearted 
work, and there was less of division of labor. The 
working man was an artisan who had the opportunity, 
and often the desire, to become an artist in his particular 
trade, and the agricultural portion of the population had 
similarly unrestricted occupations and opportunities. 

We are now living in a period of stupendously rapid 
changes. The human mind has become so extraordi- 
narily complex and inventive that it tackles problem 
after problem, allowing nothing to be called impossible. 
Specialization of labor has so divided the tasks that an 
individual only performs a part of the whole which is 
assembled by others. Machinery replaces the hand- 
work of millions and has revolutionized industry and 
agriculture. The amazing progress of the means of 



22 THE EXCEPTIONAL CHILD 

communication and transportation, over land and sea, 
under the ocean and through the air, has brought the 
life and productions of distant countries together. 
Classes and castes along old-country lines have become 
obliterated, and are slowly being replaced by divisions 
along other lines. 

Traditional American life is undergoing vast changes. 
Ever new aspirations welled up with each new genera- 
tion, driving its members to new sections of the country 
or to new spheres of labor. Besides, our country is an- 
nually absorbing great numbers of immigrants from all 
parts of the globe. The sturdy Norwegian yeoman, the 
stolid, thrifty German peasant, the mobile Russian Jew, 
the nomadic herdsman from the Hungarian puszta, the 
indolent and primitive Neapolitan lazzaroni, and many 
another representative of classes and races that have to 
this day preserved almost mediaeval conditions and hab- 
its, have been cast upon these shores to come into com- 
petition with the restless American freeman. Distinc- 
tions of race and nation, of instincts and ambitions, of 
ideals and aspirations, of education and refinement, of 
century-old culture and leadership, give way before this 
crushing flood of the new migration of peoples. 

The social and moral props — family, position, tradi- 
tion, institution, education, etc. — which sustained the 
parents and the grandparents of the present generation, 
are being torn away, and all of us, especially the immi- 
grant, must face new conditions upon our own initiative. 
The individual has an increasingly difficult task to ad- 
just himself to the rapidly changing situations, and to 
find his place in life. What would otherwise seem to be 
a most auspicious epoch for the development of a new 
brotherhood of men resolves itself into another form of 



THE PROBLEM OF EFFICIENCY 23 

the primal struggle for existence — a struggle in which 
unscrupulous, merciless cunning and brute force only 
too often secure the mastership. 

Skill vs. Efficiency. — Under these conditions innate 
competency is overshadowed among the masses of the 
people by skill. The broader aims and ideals of the 
individual, of the community, and of the nation are left 
unexplored while the masses live through their daily 
grind. 

Skill is the ability to perform a given task well. After 
the modus operandi of a task is once grasped, success in 
attaining skill depends upon perfecting the separate 
operations essential to execution, eliminating all ex- 
traneous acts or thoughts not immediately concerned in 
the operation; through repetition the sequence of oper- 
ations in each performance is fixed until conscious effort 
is fully eliminated and the nearest approach to machine- 
like perfection is reached. Thus, skill tends to reduce 
a task to a definite succession of physical and mental 
reactions, limited in number and kind, making them 
resemble simple automatic reflexes. Skill is intimately 
related to habit. Conscious adaptation and intelligence 
are reduced to a degree sufficient only for the immediate 
situation. Any change in the order or type of reaction 
immediately jeopardizes the perfection of the skill in 
that operation. Besides, the final success of skill as 
such consists in its immediate result — the thing com- 
pleted. 

The merely skilful maid may be taught to sweep the 
floor without much idea why the broom should be ap- 
plied in one way rather than in another; in contrast to 
the efficient housewife who may not possess skill in 
sweeping, but appreciates what this task implies, and 



24 THE EXCEPTIONAL CHILD 

who can therefore direct, in an organizing manner, not 
only this but many other household tasks. The skilful 
accountant, computing figures at his desk, need not raise 
the level of his conscious adaptation and intelligence 
above his task. His employer, a captain of industry 
with a wide perspective of organization and power, deals 
not simply with figures as such, but brings his executive 
leadership to bear on operations which affect much 
vaster interests than merely his counting-house and the 
accuracy of his accounts — he is a factor in the commerce 
of the world. 

By far the greater part of the ordinary tasks in life 
are based upon skill. These tasks merely represent dif- 
ferent grades of skill on varying physical and intellectual 
performance levels. Naturally, the skill required by a 
surgeon to perform an intricate resection is infinitely 
more complex than that of a butcher severing the bone 
of a carcass. The actual skill required in any specific 
instance may be measured quantitatively. The mere 
fact that a task is skilfully performed does not endow 
that skill with any moral quality. The burglar who 
opens a complicated lock may show no less skill than 
the locksmith who made it. 

Skill Quantitative, Efficiency Qualitative. — Efficiency 
needs skill as one form of its expression, but skill is only 
an applied mechanical evidence of previous ideation. 
As such it deserves careful training. Skill is appraised 
quantitatively and is confined to a limited number and 
type of acts. Efficiency is elastic in the manner of its 
application; it applies potential skill along many differ- 
ent lines of activity; it is qualitative. Skill is the result 
of special training; efficiency is a directing force from 
which skill emanates. Skill has no moral quality; effi- 



THE PROBLEM OF EFFICIENCY 25 

ciency is measured by moral standards. Skill is depen- 
dent upon immediate results such as can be measured 
in terms of money value or of some other form of prac- 
tical advantage. Efficiency may not redound in the 
form of worldly success to the benefit of the individual 
possessing it — for what he has builded may be of a nature 
which cannot bear direct fruit, or may not ripen until 
a remote future date. Men of recognized efficiency, like 
Pestalozzi (Case i) and Kepler (Case 2), powerful forces 
of progress that they were, were failures from the 
standpoint of immediate personal or worldly success. 

The efficient man comprehends the situation, selects 
the particular suggestion it contains for the purpose in 
•view, and decides upon, or invents, the process assuring 
the result. The skilful man accepts the creative con- 
tribution of the efficient man, and through practice 
reduces the operation to machine-like perfection. 

Community Efficiency. — The opportunities offered to 
the aborigines and to the early pioneers in the untram- 
melled resources of a new continent under pristine living 
conditions allowed types of men to succeed whose com- 
petency sufficed for the attainment of those forms of 
efficiency which were needed in that period of history. 
The individual performance level was low. 

With the mastery of these resources and the develop- 
ment of more complex life conditions, including "law 
and order," and advancement in civilization and cul- 
ture, as described before, new types of competency came 
into demand. Instead of the hunter who bartered the 
fruit of the chase — his venison and pelts — we now have 
the sheep farmer, the stock breeder, the clothing manu- 
facturer, etc., with the host of those whose occupations 
mediate between these producers and the consumers. 



26 THE EXCEPTIONAL CHILD 

Instead of the trader who collected the products of the 
woods, the fields, and the streams, we now have the 
commercial centres, the brokers, the middle-men, the 
exchanges. The cruder forms of efficiency have receded 
to remoter regions, where they still exist in primeval sim- 
plicity. 

Now, communities tend to crystallize into definite 
types — types representing different combinations in 
competency, just as is the case in individuals. These 
community types are founded on some phase of indus- 
trial, commercial, agricultural, or purely intellectual life. 
Examples of such community types are well known: we 
have the shoe factory or foundry centre; the export or stock 
exchange centre; the cotton, wheat, or cattle-producing 
centre; the university centre or scientific laboratory, etc., 
ad lib. Even in our most cosmopolitan cities the popu- 
lation splits itself into groups about definite life occupa- 
tions and neighborhood activities. 

Localization of Industries. — The tendency in a given 
locality is to confine variation to definite lines. The 
general opportunities, such as existed but a few genera- 
tions or even decades ago, are dwindling away, and 
communities are drifting more and more into specialized 
activities. This narrows down the opportunities of the 
citizens so that in the main only those will develop effi- 
ciency increments whose combination of endowments fits 
into the specialized aims of the community. Further- 
more, such a high performance level will be demanded 
that only those of rarer quality will survive as indepen- 
dent factors. 

Those whose combinations of endowments are out of 
harmony with the types in demand will have greater 
difficulty to develop and utilize their competency, or to 



THE PROBLEM OF EFFICIENCY 27 

raise their performance level above a circumscribed level 
of skill. Thus, every community loses potential incre- 
ments of efficiency in great numbers — of the rich supply 
of potential competency only a small portion is inten- 
sively developed to an efficiency level. The rest remains 
dormant, or flickers out of existence from disuse. The 
individuals are reduced to a mass of "wage-earners." 

Skill in the special activities of the community is the 
general substitute for dwarfed competence — skill which 
scarcely touches the mainsprings of the true self in num- 
berless instances. Occasionally we speak of "ineffi- 
cient" individuals in another sense, meaning thereby not 
those who could be truly efficient if they had the oppor- 
tunity, but those whose competence is so different from 
community demands that the individual cannot even 
attain skill in the specialized activities there existing. 
This is not a new thing. Even in the villages of old, 
the "ne'er-do-well" was merely a misplaced individual. 
Poets, painters, musicians, philosophers, even inventors 
and builders may be very useless and inefficient beings 
in communities requiring different types of competency. 

Factory Methods. — In former times the shoemaker 
made the entire shoe. His standing in his trade was 
measured not merely in terms of skill, but in terms of 
efficiency, by the extent of his intelligence and of other 
qualities which he showed to improve the process of 
manufacture and to produce a better article with each 
new effort. His knowledge of shoes and their manufac- 
ture was comprehensive and progressive. 

To-day it is not the efficient artisan who produces 
our shoes; it is the factory. Shoemaking has become 
a science and has been mastered in its entirety by a 
relatively small number of men whose efficiency lay in 



28 THE EXCEPTIONAL CHILD 

that field on a high performance level. The process of 
production is carried out by machines and by hundreds 
of feeders of machines, each skilled in one operation, 
complete in itself, but only a part of the whole process. 
This tendency to reduce the occupation of the indi- 
vidual to a most definite and eventually simple and 
automatic form may be observed in most of our indus- 
trial and commercial pursuits. The "efficiency stand- 
ards" of our "efficiency experts" are really concerned 
in the reduction of the tasks of efficiency to tasks of 
skill. At one time the author watched a number of 
youths of both sexes arranged along a long, broad table 
in a certain part of a large soap factory. Machinery 
shoved an endless procession of cakes of soap before 
them, which they had to pick up and pack by dozens 
into pasteboard boxes which lay in stacks by each work- 
er's side. Their task was to dispose of the cakes of 
soap as fast as they came along. The workers' worth 
to the factory owner was judged by their skill in doing 
this one thing. In another place were pairs of girls 
occupied in filling small bottles with perfume, which 
spouted forth at regular intervals in mechanically mea- 
sured quantity from a machine. ' One girl filled the 
bottles and corked them; the other shoved the bottles 
toward her with one and the same monotonous jerk of 
her right arm and hand. Again the workers' value to 
the employer consisted in their skill to do this work, 
machine-like and at a required speed. Throughout the 
factory each worker did some one limited act for eight 
or ten hours a day — day in, day out, for weeks-, per- 
haps years. This is a typical example of the entire 
method. Of course there are many varieties of occupa- 
tions, and many differences in the degree of intelligence 
required to maintain a given performance level of skill. 



THE PROBLEM OF EFFICIENCY 29 

This is a matter not of giving individuals the oppor- 
tunity to express themselves in terms of their own best 
and efficient selves, but of forcing them to adjust them- 
selves to community demands which may afford them a 
"living." 

Efficiency and National Ideals. — Just as the com- 
munity represents the various available increments of 
its individual citizens, so does the nation depend upon 
the efficiency and skill increments of its entire popula- 
tion. As a nation America possesses a wonderful com- 
bination of endowments in its natural resources, in its 
government and history, in its geographical advantages, 
in its human stock; a combination of physical, intellec- 
tual, emotional, and spiritual endowments in which rare 
natural gifts of earth, water, and climate offer unlimited 
possibilities to a heterogeneous and virile people. 

This combination tends to give the nation as a whole 
a distinct competency, and gives to all its activities a 
certain trend. This trend has many phases and is ob- 
servable in the country's industrial and commercial de- 
velopment, in the form of its government, its social life, 
in the physical and mental health of its peoples, in its 
intellectual progress, in its position among the nations. 

Our country is based upon the conception of demo- 
cratic government. But the idea of a truly democratic 
efficiency of the whole people is yet in its infancy. Cer- 
tain forms of individual and community efficiency have 
been highly developed, but they lack relation to a 
national plan — they have in many cases not only been 
wasteful of national resources and assets, but have been 
detrimental to all other types of latent, undeveloped 
forms of true national efficiency. 

In order to develop this national efficiency, we must 
first take stock of the nation's truly characteristic en- 



30 THE EXCEPTIONAL CHILD 

dowments. There are its physical and geographical 
possibilities in resources and trades. Then we have the 
far more important factors of the character and types 
of our composite people. We are moulding all races of 
the world into a new unity. This means a tremendous 
force of unique possibilities. Community development 
in America has taken an interesting trend which has a 
distinct national bearing. Specialization in efficiency 
for industrial pursuits has produced a new kind of "com- 
munity," which goes beyond local interests and geo- 
graphical contiguity and is national in scope. The 
binding force of some special interest has welded distant 
parts of the country together. We have but to think 
of our huge iron and steel interests; our oil, coal, tobacco, 
cotton interests — each organized under efficient leader- 
ship so as to embrace the entire production of the com- 
modity; we may think of our labor-unions, our national 
societies, political parties, etc. Much of this wonderful 
development is desirable and the result of a marvellous 
display of efficiency; much, also, is undesirable, because 
anticivic, and must give way before a higher national 
idealism. 

The nation must define its aims and recognize its 
ideals. Are its aims in industrial and commercial life 
to organize national community methods such as its 
"captains of industry" are practising? To foster fac- 
tory methods such as above described ? If so, ihe nation 
must take its course with a clear knowledge not only of 
the facts, but of what its course means as a national 
policy. 

If a majority of the increments making up the prog- 
ress of this nation must forever be based on skill only, 
while the tasks — for the execution of which this skill is 



THE PROBLEM OF EFFICIENCY 31 

required — are planned out by a few efficient leaders, let 
us recognize this as a situation to be faced. But it would 
mean a sorry shipwreck of democratic ideals. 

Democracy and Efficiency. — The plan of democratic 
government rests upon the tenet that there must be 
opportunity for all of us to appreciate the various phases 
of the country's problems, to recognize the material and 
spiritual opportunities for social betterment, and to give 
of our own best selves, by ballot or in actual service, for 
the good of our fellow citizens. If we wish to remain 
true to the democratic ideal, how shall we reconcile this 
with the actual tendency to give opportunity for effi- 
ciency only to the few, and to restrict the many to cir- 
cumscribed skilled occupations? 

To harmonize the democratic ideal with actual condi- 
tions, we must make a careful survey of our population, 
differentiating our citizens into broad groups represent- 
ing types. We must preserve and cultivate the com- 
binations of endowments such groups represent, so that 
efficiency increments on a national basis may be obtained 
from large numbers of individual members of each group. 
Further, if it is discovered that efficiency increments 
cannot be secured or even expected of every individual 
citizen; that there exists a percentage of individuals 
who have no efficiency stamina, or whose stamina it is 
not practical to develop; we must at least provide op- 
portunities to raise their performance level in skill of 
constructive kind to a higher plane. Thus, the process 
of conserving the competency of the individual will re- 
flect itself in the conservation and evolution of the 
national competency. 

National Tendencies and the Public School. — "Voca- 
tional training and guidance" has become a popular 



32 THE EXCEPTIONAL CHILD 

phrase, a sort of slogan. Such training and guidance is 
ostensibly to be a means of producing greater individual 
efficiency in various occupations, by selective training in 
harmony with individual competency. It has been sug- 
gested that by scientific study the individual competency 
can be discovered, conserved, and developed for the 
good of the student and of the community. School au- 
thorities have realized the importance of this demand. 
But from lack of a clear-cut conception of the larger 
aims and of the individual potentials they have been 
unable to arrive at a satisfactory solution of the many 
problems involved. Failing to discriminate between the 
community and national issues entering into this prob- 
lem, failing to realize the need of individual differentia- 
tion, they are cramming their pupils with a mass of 
unnecessary and indigestible material. 

Or, heeding the extreme claims of the advocates of 
specialized rather than common education, some school 
systems have patterned their organization upon the 
general outlines of industrial organizations, developing 
many branches or departments of special instruction, so 
that the pupil be enabled to focus his entire attention 
upon some definitely circumscribed training. These 
systems endanger the true purpose of the schools — the 
education of efficient boys and girls. Of course it is 
important to increase skill; or, rather, to raise the per- 
formance level from a simple to a more complex skill. 
But is skill of any degree or type the sole object of our 
schools ? Is it their purpose to feed factories with girls 
who can attain a higher speed in packing soap or filling 
perfume bottles? Is it our aim to concentrate the edu- 
cation of boys upon greater skill in fastening so many 
dozens of heels a day to ready-made shoes, or to start 



THE PROBLEM OF EFFICIENCY 33 

levers which in turn will set in motion thousands of 
spindles, or to handle a typewriter, or to count up fig- 
ures? Would not the object of such an educational 
factory be nothing higher than to produce human ma- 
chines for the regular industrial factory, the office, the 
store ? 

The examples cited represent low performance levels 
of skill. But is there any essential difference in educa- 
tional aim if we give the pupils a "practical" preparation 
for the skill demanded in the banking-house, the rail- 
road, etc., which varies from the lower forms, if they be 
lower, only in type or degree, but not in essence ? Will 
education so circumscribed in scope conserve and con- 
vert competency into dynamic forces of efficiency? 

School men must clear up their conceptions of com- 
munity aims and national ideals. They must meet the 
demands of the more powerful tendencies more ade- 
quately. We must bear in mind that the best individual 
increment is the efficiency increment. This is based upon 
special competency which needs to be developed to its 
highest perfection. It is the educator's problem to 
harmonize individual efficiency with community needs 
and national aspirations. 

The Public School and Individual Efficiency. — Our 
schools must take it into account that individual endow- 
ments differ, and that these different endowments pre- 
dispose to differentiated work. The whole field of possi- 
bilities which the true ideal of efficiency presents must 
be explored. 

Perhaps there will always be a residue of persons who 
can do no more than start levers of machines, or be 
hewers of wood and drawers of water. For such, skill 
and efficiency are so nearly identical that they mean lit- 



34 THE EXCEPTIONAL CHILD 

tie to the progress of the nation. But aside from this 
almost negligible residue we have the millions of children 
who represent human raw material of immense possibili- 
ties. To condemn them to life-long slavery in machine- 
like occupations which will be more and more assumed by 
real machines is a great wrong to them and to the nation. 
They contain potential competency of every variety 
which is lying fallow until worked to a high state of effi- 
ciency through the aid of education. Many of them 
may become inventors of devices and machines which 
will replace human slave-labor. Each individual is ca- 
pable of being matured in his own right only; he must 
have the chance of expressing his own life attitude in 
his active pursuits. 

It is efficiency which creates, promotes, and increases 
material and spiritual progress. Efficiency, in the last 
analysis, is the result of a man being fully himself. It 
implies the development of the individual as an individ- 
ual to his full possibilities. It presupposes that the in- 
dividual is conscious of his powers and knows how to 
project them upon his environment. It implies the 
power of self-management and self-direction — the vision 
of human development and cultural growth — the enjoy- 
ment of cultural existence. It is the expression of ster- 
ling character, honest work, of motives that go beyond 
individual narrowness, and which serve the ideals of 
national betterment and the progress of civilization. 
Efficiency points high; it points to perfection; it points 
to godliness. 



CHAPTER III 
DIFFERENT CIVILIZATION LEVELS IN MODERN SOCIETY 

Many Different Types of Men. — There are all kinds 
and manners of people. This is an old truism. There 
are the bold and the meek, the noble and the vicious, 
the successful and the failures, the leaders and the led. 
We meet with surprising specimens of humanity every 
day. All these different kinds and types of people are 
foreshadowed in the children of the nation. They will 
grow up to be the boors, the gentlemen, the workers, the 
philosophers, the dreamers, the libertines, the cowards, 
the bravadoes, the saviors, and the criminals of the rising 
generation. 

In the previous chapter we have discussed the prob- 
lems of efficiency and skill in their relation to individual 
and community problems and to national progress. We 
found that there are different levels of intelligence, of 
performance, of endowments — physical, mental, moral. 
We might be tempted to dismiss the problem of differ- 
ence among people without further discussion, merely 
mentioning in addition the different opportunities of 
education and environment; effects of disease and of 
neuropathic conditions, and a host of other causes which 
are generally cited in discussions of this kind. 

But there are deeper causes, and this chapter is de- 
voted to a study of certain evolutionary factors which 
will explain to us the biological facts which have led 
to a differentiation of types. 

The theory here advanced is that we are dealing with 

35 



36 THE EXCEPTIONAL CHILD 

different civilization levels, and that each individual repre- 
sents mental and moral attitudes characteristic of one 
or several of these levels. Many, or most, in fact, are 
mixed types. 

Primitive Man. — Early man, like the animal, acted 
largely upon impulse, without considering consciously 
the effect of his acts. His actions were in the nature of 
slowly developed but deeply ingrained instincts and 
reflexes. Life conditions being simple, the thought- 
process required for individual adjustment was minimal 
as compared with modern requirements. The ability 
to inhibit immediate reaction to impulse is characteristic 
of higher mental life, of the development of higher brain 
centres with their associations of ideas: of civilized man 
as we understand him to-day. 

It is true enough that the primitive conquest of fire 
and of the wild animals, the solution of the problems of 
shelter, of the manufacture of implements and of weap- 
ons, of pottery and of clothing, and other fundamental 
human achievements were of tremendous moment. But 
the individual increment to the progress of civilization 
was very small. Where we now reckon with decades, 
primitive advance reckoned with hundreds and thou- 
sands of years. The process of civilization has indeed 
been long, and its primordial beginnings demanded cen- 
turies of adjustment to fix each slight gain. 

Among savage peoples there were seldom any defec- 
tives, "degenerates," or feeble-minded. It is claimed 
that as civilization progresses the number and variety 
of low types increases. This claim, although apparently 
well substantiated, is to be accepted with caution and 
reservation. We must study the composition of modern 
society from many view-points, so that we may really 



DIFFERENT CIVILIZATION LEVELS 37 

know the laws governing it in order to avoid errors in 
analysis and deduction. 

Primitiveness vs. Deterioration. — Many have become 
accustomed to ascribe all cases of low mentality and 
morality to deterioration, a dropping down from a higher 
state of civilization to a lower form. Such degeneration 
and deterioration is undoubtedly observable in certain 
individuals in whom physical disease and psychopathic 
condition produce a dissolution of the higher functions. 
This dissolution brings the lower centres into uncon- 
trolled activity and causes a reversion to primitive forms 
of mentality. To a lesser extent the charge of deterio- 
ration is also true when successive generations continue 
to decline in physical well-being and mental health, 
showing a disintegration of family traits, of tribal and 
racial elements; in short, of stock. Again, we have had 
psychic epidemics sweep over entire countries and con- 
tinents, like the hysterical frenzy of the flagellants in 
the thirteenth century, and other outbreaks of morbid 
fanaticism, religious, political, or otherwise, at all times. 
There are various popular crazes even at this period 
(like the tango craze, the war craze, etc.), which cause 
a temporary dissolution of the elements of contemporary 
civilization and often assume the form of distinct popu- 
lar manias. 

But we are apt to overlook the fact that every large 
community of the present time contains many elements 
of primitive constitution, of a retarded mental develop- 
ment which has been behind contemporary progress 
ever since time began. Here we have a problem en- 
tirely different from that of deterioration. Instead of 
degeneration — which is a condition of falling from a 
high to a low state — a condition of low development con- 



38 THE EXCEPTIONAL CHILD 

fronts us, a development which has never reverted, but has 
ever risen — very, very slowly, it is true, but nevertheless 
representing an upward, even though greatly retarded 
movement. A closer study of individual evolution con- 
vinces us with increasing force that primitive or retarded 
development, in the sense here described, is far oftener 
the cause of failure in life under present-day conditions 
than has been suspected. And this retardation must 
not be confused with pathological retardation, or with 
f eeble-mindedness . 

Much has been said by some pessimistic philosophers 
about the sad future of the race if deterioration be 
allowed to go on unchecked, and "eugenics," often of a 
spurious kind, has become a scientific slogan. Little, 
however, has been done to diagnose even approximately 
the extent and varieties of primitive elements mixed 
with every community of the civilized area of the world. 
We must revise our methods of approach in sizing up 
the social misfit, the disturber, the dead-weight. In- 
stead of branding an individual, with a shrug of the 
shoulders, as a "misfit," we should try to discover how 
far he may fit, judging his position in the scale of social 
usefulness by the measure of hi's competency. This will 
show how much he is lacking, surely — but not through 
being "defective," but through being a representative 
of earlier forms of civilization. Thus we may rank him 
properly and discover methods of "fitting" him and 
raising him in the scale. 

Simpler Mental Constitutions. — With the increasing 
complexity of modern life demands, as has been shown 
in the previous chapter, an infinite variety of situations 
is created which handicap the simpler mental constitu- 
tions. What had been a normal standard during the 



DIFFERENT CIVILIZATION LEVELS 39 

childhood of the race, or under generally more primitive 
conditions (even those of our period of pioneer settle- 
ments), naturally lies far below the level of modern de- 
mands. In many cases the strain produced by these 
demands upon the simpler mental constitutions may 
reach the breaking-point, then causing true reversion. 

The conduct of an individual of this type will be 
normal under the stimulus of earlier instincts, and of 
primitive methods of thought and reaction, under con- 
ditions commensurate to his constitution. These condi- 
tions are, however, opposed to modern social conduct. 
To him, modern social organization offers many restric- 
tions — on the other hand, offering many opportunities 
for temptation. Through these temptations which give 
an outlet to his most primitive instincts, he may be led 
into mental disintegration, which predisposes him to 
complete failure. But if the true status of such an in- 
dividual is rightly understood in childhood, he may be 
helped to fill his place in life. His competency must be 
conserved and the performance level of his skill and 
efficiency must be developed rationally, not brushed 
aside and ignored, or underestimated in value through 
the force of overspecialized community demands. He 
must be given an outlet to make his endowments a 
constructive force. It may mean a proper distribution 
of individuals in places where they best fit. The peas- 
ant boy who is quite efficient in his home environment 
is apt to fall by the wayside when reduced to a factory 
hand under the congested conditions of urban life and 
competition. Such a life is too remote from his natural 
method of thinking and living. Not infrequently he 
will seek forgetfulness, or the illusion of strength and 
self-satisfaction, in dissipation and drink, and thus lower 



40 THE EXCEPTIONAL CHILD 

his chances of success still further. His children, grow- 
ing up in an atmosphere of strain, of the unequal strug- 
gle of a primitive equipment pitted against modern life 
standards, will lack vitality, and may become mental 
defectives, as they are physical defectives, the victims of 
malnutrition, poor housing, lack of air-space and of 
joyful exercise. Factory girls, immigrants from foreign 
lands, have been shown to develop various kinds of 
psychoses, through the effect of economic pressure. 
Certain primitive races, like the North American In- 
dian, have been practically wiped out for the same 
reason by the advance of civilization. 

Individual Evolution. — It has been experimentally 
shown that the so-called "culture epoch" theory, first 
crudely formulated by the German philosopher Johann 
Friedrich Herbart (1804), and later by his disciple, Ziller, 
is essentially true. The author's own investigations, 
coupled with the work of other research students, have 
permitted a modern formulation of this theory. 1 

This theory implies that each individual born into 
this world passes from infancy to childhood and ma- 
turity through a series of developmental stages which 
broadly represent the consecutive stages of civilization 
through which the human race has passed. The paral- 
lelism between the conduct and work of children and 
that of savages and ancients is truly striking. It can be 
observed that the same biological laws which have de- 
termined the growth of the human mind in the race are 
still at work in the evolution of the child soul from in- 
fancy to adult age, and shape the child's conduct at 
different stages. Of course an American child is at no 

1 Cf. "The Career of the Child," pp. 90 jf., and "Some Fundamental 
Verities in Education," pp. 94 jj. 



DIFFERENT CIVILIZATION LEVELS 41 

time an Indian, or an Assyrian, or an Egyptian. But 
his methods of thinking, feeling, and symbolizing, his 
instinctive activity, the sequence of his modes of con- 
duct, will reincarnate the development of the race. All 
children pass through a sequence of epochs, although 
not every one passes through all the details of epochal 
characteristics; nor do all pass through the different 
periods in exactly the same way or at the same rate. 
Variation is caused by different sets of hereditary and 
environmental influences. An adult will, therefore, 
show a mixture of modern and primitive traits, tenden- 
cies, attitudes, and instincts. 1 

The author has roughly divided the life of a child 
from babyhood to maturity into five divisions: the 
period of infancy, the primary or childhood period, the 
elementary or boyhood period, the intermediate or 
pubescent period, and the advanced or adolescent period. 

The Infancy Period (from birth to 2 or 3 years) may 
be described in the words of Professor James as the one 
in which a living thing is thrust upon "a big, blooming 

1 "Other voices screamed through my voice, the voices of men and 
women aforetime, of all shadowy hosts of progenitors. And the snarl 
of my anger was blended with the snarls of beasts more ancient than 
the mountains, and the vocal madness of my child hysteria, with all the 
red of its wrath, was chorded with the insensate, stupid cries of beasts 
pre-Adamitic and pregeologic in time. . . . The red wrath is my dis- 
astrous catastrophic heritage from the time of the slimy things ere the 
world was prime. . . . Just as the human embryo, in its brief ten lunar 
months, with bewildering swiftness, in myriad forms and semblances a 
myriad times multiplied, rehearses the entire history of organic life from 
vegetable to man; just as the human boy, in his brief years of boyhood, 
rehearses the history of primitive man in acts of cruelty and savagery, 
from wantonness of inflicting pain on lesser creatures to tribal con- 
sciousness expressed by the desire to run in gangs. . . ." — Jack London 
in his book, "The Star Rover," which is at the same time a frightful im- 
peachment of modern prison methods in all their cruelty, and a fasci- 
nating romance of the human race. 



42 THE EXCEPTIONAL CHILD 

confusion," having to make the discovery that it is an 
entity distinct from this confusing environment. 

During this first period and the second, the Primary 
Period, the human species differentiates itself from the 
lower creation. Animal traits merge into human char- 
acteristics, and the beginnings of human thought and 
conduct are achieved. 

The Elementary Period (from about 6 to n years) is 
the "race period." These years represent the stage in 
which race characteristics are evolved from the general 
human potentials. 

The Intermediate Period (12 to 15) is the nation- 
forming, the pubescent period. 

The Advanced Period (16 to 21) is the time when 
family and individual traits will manifest themselves 
more strongly. This is a period in which maturity 
finally shapes itself into a definite life trend for the 
individual. 

In considering individual evolution several factors must 
be taken into account. The periods mentioned cannot 
be definitely circumscribed, neither in their length nor 
in the exact order or type of their manifestations. Each 
individual is by heredity a distinct combination of en- 
dowments, which will determine in a measure the entire 
individual evolution. Upon this evolution will finally 
depend the potential competency of the individual. Men- 
tal and physical growth may be normal and healthy, or 
weak and abortive. Each individual will pass through 
the successive stages at a different rate of speed and 
completeness. We are all more or less advanced in cer- 
tain directions, as determined by our own peculiar com- 
bination and by opportunities of development. We are 
also distinctly primitive along other lines. Some of us 



DIFFERENT CIVILIZATION LEVELS 43 

will reach maturity, that is to say, the level of modern 
civilization, rapidly; others will lag behind; still others 
will never reach it. Their "maturity" will remain 
below the modern level. In the same way, we have 
entire races which are backward if measured by the 
standard of our American civilization — either altogether, 
or in certain particular lines of development. 

Competencies will differ in different individuals and 
determine individual careers. Talents and genius will 
rise up at the expense of other, weaker potentials. The 
artist often lacks business sense; the merchant may be 
without a true valuation of poetic beauty, or be anti- 
social in his aspirations. Some of us may enjoy reading 
Browning, or combine commercial success with the abil- 
ity to compose music; yet, when asked to draw a figure 
or a landscape, we may employ a primitive method 
which has not advanced beyond the clumsy symbolism 
of the ancient Egyptian or the North American Indian. 
The author knows a lady of culture and refinement who 
by preference uses her fingers for counting, like the sav- 
age, in order to facilitate some problem of household 
accounts. 

Inasmuch as individual evolution depends upon the 
development of higher performance levels of skill and 
efficiency in terms of competency, it is essential to under- 
stand the innate individual combination of aboriginal, 
dormant, and submerged traits with those virile, plastic, 
expansive, modern potentials upon whose development we 
usually concentrate our efforts. The aboriginal traits 
are really the stronger, for they are the oldest ones, 
established at the beginnings of history, and every one 
of us has them deeply ingrained in the fabric of his soul. 
The modern traits, being younger and less strongly in- 



44 THE EXCEPTIONAL CHILD 

trenched in our system, are like delicate plants, needing 
much care, so that the weeds of uncultivation may not 
overrun them. Neglect or disease disarranges this top 
layer of culture first, so that the older strata erupt. 

Influence of the Environment. — It is therefore of the 
utmost importance to estimate rightly the influence of 
the environment. Upon it depends an individual's 
chance for developing his particular ability, just as a 
seed will thrive on good land, but die on sterile soil. 
Where educational facilities are inadequate, where social 
demands are restrictive, where economic pressure ex- 
cludes forms of skill and efficiency unessential to imme- 
diate community needs, individual progress may be 
warped, unless there is an element of volitional power 
which sets the individual strongly against the local cur- 
rent, or which enables him to free himself from local 
bondage, through emigration or otherwise. 

Repression, perversion, or lack of exercise of the bud- 
ding possibilities cause irregularities in the progression 
through the developmental periods. Normal maturity 
is retarded or futilized, and the individual cannot cope 
with the demands of his place and time. In effect, 
mainly the lower, primitive, normally submerged po- 
tentials remain active while competency in the higher 
functions disintegrates. Many individuals, for this rea- 
son alone, remain practically stationary in their devel- 
opment and come to represent either an obsolete type 
or a reversion to earlier periods of civilization. 

Cultural development of the individual is, then, not 
concentric, or vertically striving upward in parallel 
branches which issue from the primitive trunk with 
equal speed. A man does not reach the modern level, if he 
reaches it at all, evenly and simultaneously with all his 



DIFFERENT CIVILIZATION LEVELS 45 

faculties. He may "get stuck" in earlier stages in some, 
or even many, of his mental faculties. It is for this 
reason that the struggle for existence is still so primordi- 
ally crude and brutal, in spite of our modern "culture" 
— not only among individuals, but among nations. How 
far this goes, how much of the savage is still alive in 
modern man, has been terribly and discouragingly dem- 
onstrated by the awful world-wide war which is raging 
at the time of this writing. 1 

Civilization Levels. — The crimes of the "Black Hand," 
the "Camorra," the "Mafia," etc., as they occur in this 
country as reverberations of Old World conditions, illus- 
trate the eruption of primitive impulses in racial groups 
which are not far removed from earlier forms of civili- 
zation. In semicivilized nations, revolutions, political 
and social disturbances, and similar elemental events, 
sometimes lead to a true reversion to the savage type of 
their ancestors, as has recently been observed in Mexico 
and in some districts of China. Richard Barry gave an 
interesting story of a wealthy American who succeeded 
in saving his life while a captive in the hands of the cruel 
Mexican bandit leader, Zapata (Case 3). This is part 
of the story: 

That night the American slept in the bandit camp, a dozen 
miles away in the hills. In the middle of the night he overheard 
two of the bandits whispering. "What will you do with him 
after vou kill him ? " asked one. " Cut out his heart and take it to 
my old woman." "What for?" "She'll cook it." "Wretch," 

1 Doctor George W. Crile, in his book " A Mechanistic View of Peace 
and War," describes the effect war has upon man. He strips, with no 
gentle hand, the coat of convention with which civilization clothes the 
primeval man. War, with all its horrors, according to Doctor Crile, re- 
veals man as he really is. He quickly reverts to a fighting demon, whose 
only purpose is to kill. 



46 THE EXCEPTIONAL CHILD 

replied the second bandit. "You are too much like a soft 
Gringo. Eat it raw!" 

The mine-owner knew that this was a commonplace and 
serious conversation among primitive men whose ancestors had 
been savages, and who now in anarchical upheaval were reverting 
to type. Fortunately, however, he also knew that they were 
children as well as savages, and could be diverted if he could 
but properly appeal to their irresponsible instincts. In the 
early dawn he called for Zapata, and told him he possessed two 
marvellous fighting-cocks which he had long been preparing for 
combat on the coming Sunday. Zapata instantly was eager to 
get the cocks, and the immediate followers who overheard the 
conversation quickly forgot, apparently, their intention of mur- 
der, or at least postponed it. Zapata offered to have some of 
his men go back with the American and get the cocks. 

They were about to start when, as an afterthought, the Ameri- 
can turned back to the leader and said he would not reveal the 
whereabouts of his cocks unless the bandit chief agreed to let 
him off with his life; and he thereupon revealed that he had 
overheard the conversation of the night before. The Mexicans 
who overheard this laughed immoderately, rather pleased with 
the Americano's shrewdness. Zapata put the question to a vote 
among his men, and they unanimously agreed to let the Gringo 
live if he produced two good game-birds. That he had given up 
his money had not mollified them, but that he was willing to give 
up his fighting-cocks, and at the same time was clever enough 
to demand his life in exchange for them, they were more than 
pleased. 

In fact, he returned under escort with the cocks, stayed and 
watched the ensuing fight, in which one was killed, and then 
before he departed on his way for the city of Mexico, Zapata 
opened a bottle of champagne and drank his health. 

Modern Reverberations. — In all these cases we are 
confronted with a more or less primitive mental and 
emotional condition, an undeveloped conception of right 
and wrong. If we study the development of the idea 
of property, for example, and of respect for other people's 



DIFFERENT CIVILIZATION LEVELS 47 

property, or of the sanctity of human life, we shall be 
surprised to find conceptions and customs of only a few 
centuries ago (and even now in some places on the globe) 
to be greatly at variance with our own, or what we think 
are present-day conceptions. Sometimes the seemingly 
primitive instincts, or modes and manners of living, of 
thinking, feeling, and acting; or the crude and coarse 
tendencies of children who are branded as being sub- 
normal, or even abnormal, do not really point back to 
very ancient levels of civilization and culture. The re- 
finement of instincts of which we boast, the appreciation 
and practice of habits and manners which are not only 
more polished but based on purer thought and kindlier 
consideration for others, are relatively recent things. 
Our own great-grandfathers differed very much indeed 
from modern conceptions of refined mental and moral 
habits. Table manners, matters of cleanliness and pri- 
vacy, the relation of man to woman, the conception of 
private rights and personal liberty (think only of the 
New England Blue Laws), the relation of master and 
serf, and a thousand other things illustrate this. Super- 
stitions of all kinds are not very long extinct — if we feel 
justified to assume that they are now; and yet they 
reveal an unreasoning mind, unconscious of modern 
knowledge. Public education, with reading and writing 
for the masses, marks a very recent stage of civilization. 
The Dame schools of the New England of a century ago 
were of the most rudimentary character. All this indi- 
cates not only, as it might first appear, differences in 
opportunity and provisions, but deeper differences in 
aptitude and attitude. The peasant populations of some 
European countries have preserved to this day many of 
those mental and moral conceptions and customs which 



48 THE EXCEPTIONAL CHILD 

to the modern American mind seem shocking. As immi- 
grants they bring them among us, and thus there will 
occur clashes of moral and mental attitudes which some- 
times land them in the clutches of the law. 

It may be difficult to study, to discover, and to locate 
different culture levels and to determine their exact 
place among us, or their origin, and the conditions which 
have caused cultural backwardness in each case. But 
there are examples of cases all around us, and some will 
be characterized in later chapters, notably those on de- 
linquency and prostitution. Bygone notions are re- 
flected or reverberated in the minds of those atavistic 
individuals whom we call criminals. The impartial 
alienist and the open-minded psychologist can judge the 
causes and conditions of these better than the jurist. 
As in the instance of the sensational trial of the 
McNamara brothers in Los Angeles a few years ago, 
and of similar revelations in the bitter struggle for a re- 
adjustment of social and economic relations, we are con- 
fronted with a condition which is not always clearly 
understood. We are here dealing with primitive prac- 
tices in modern garb. Individuals of this type are, in a 
sense, representatives of primordial instincts which come 
to the surface in this economic strife: in the fierce and 
elemental struggle for existence, for the preservation of 
life — that first and most powerful racial instinct which 
releases primitive promptings of savage power. 

The selfishness of many of the wealthy employers, 
the unscrupulous greed of many a captain of industry, 
belong in the same category. The gambling spirit which 
has made itself so conspicuous in our amusement-crav- 
ing, neuropathic age — in card-games as well as at the 
Exchange, in book-making and in many other ways — 



DIFFERENT CIVILIZATION LEVELS 49 

reminds one forcefully of the barbaric epoch in human 
civilization when man lived from hand to mouth and 
depended upon chance rather than purposeful planning: 
the chance of the hunt and the weather. The devil of 
gambling is truly a fetich of savage man — an idol to 
whom sacrifices of human lives and happiness are made 
even to-day by those whose intellectual level represents 
an undulating plane, with higher peaks of culture and 
depressions of barbarism. 

Strata vs. Individuals. — The more closely we analyze 
the human stock of any nation the more apparent it be- 
comes that there are not merely individuals but whole 
groups, or strata, representing either survivals of obso- 
lete types, or typical reversions to earlier periods of 
civilization. In radical upheavals such as are caused 
by attempts to reorganize the social fabric, these deeper 
levels of culture are oftentimes brought to the surface, 
just as in the formation of the earth's crust earlier strata 
have been forced to the top by volcanic action. Where 
the national unit is weak because of lack of broad ideals 
and aims, where the consciousness of culture is but 
poorly developed, where the different elements compos- 
ing the nation are but recently assembled and imper- 
fectly assimilated, there is the constant problem of 
police control, relief from poverty, public and private 
charity, reconstructive agencies of all kinds, to keep up 
the equilibrium of modern conditions. The strata here 
referred to are characterized by a certain helplessness 
and recklessness; there is lack of practical ability to 
size up situations and strenuous life conditions — they 
live care-free from day to day, not thinking of the mor- 
row. 1 

1 The primitive recklessness of his buccaneers is well described by 
Robert Louis Stevenson in "Treasure Island." In one place he says: 



50 THE EXCEPTIONAL CHILD 

These various deeper levels of civilization are not to 
be diagnosed as potentially or actually feeble-minded or 
"low grade," or as progenitors of a degenerate race. 
Unrecognized and unprovided for, educationally speak- 
ing, they doubtless supply their quota of paupers, of in- 
effectives, of the jobless. They cannot plan, or concen- 
trate, or endure. "They sow not, neither do they reap, 
nor gather into barns" — yet our charity feedeth them. 
Many of them are the tramps, the vagrants, the despair 
of all those who endeavor to organize their life in an 
"orderly" manner. Their sense of honor is primitive — 
they are just a mass, a clumsy mass. The proper dis- 
tribution and disposition of these strata is a grave prob- 
lem. It is a matter of redemption through generations, 
for the children of this type possess the rudimentary 
potentials of cultural progress. 

Composite American Stock. — Lower, or deeper, civili- 
zation strata exist in every nation. There are sometimes 
racial differences, such as are represented by the rem- 
nants of the conquered tribes within the conquering race. 
Again, we have the condition of geographical isolation 
within a nation which may cause an entire group to 
develop independently and more slowly than the other 
national groups. Such is the case of our "contemporary 
ancestors" in the mountainous back yards of Virginia, 
Tennessee, Kentucky, and the Carolinas. To this con- 

"They had lit a fire fit to roast an ox. . . . In the same wasteful spirit 
they had cooked . . . three times more than we could eat; and one of 
them, with an empty laugh, threw what was left into the fire, which 
blazed and roared again over this unusual fuel. I never in my life saw 
men so careless of the morrow; hand to mouth is the only word that can 
describe their way of doing; and what with wasted food and sleeping 
sentries, though they were bold enough for a brush and be done with it, 
I could see their entire unfitness for anything like a prolonged cam- 
paign." 



DIFFERENT CIVILIZATION LEVELS 51 

dition we must add political and social factors which 
have caused the repression of entire layers within peo- 
ples, checking their mental uplift. Here we have the 
typical peasant, the prototype of the proverbial "boor," 
whose mental horizon is extremely narrow, owing to 
the isolation and oppression which have been his lot 
for centuries. These fragments and relics of bygone 
times had been left untouched by the progress of civili- 
zation above and about them. They embody to this 
day mediaeval and even primitive life conditions and 
instincts. 

The mixing of these elements with more progressive 
ones, as brought about by modern modes of travel and 
industry, does not immediately or intrinsically change 
them into modern cultural material. It must be again 
emphasized, however, that backward development of this 
kind must not be classed with arrest of development. Most 
of these elements have latent powers of cultural ad- 
vance. They will constitute valuable increments for 
future epochs. 

In our own country, where all these different old-world 
types are assembled, we have a particularly complex 
mixture of progressive and primitive elements. The dif- 
ferent nations represented here, even as national units, 
present not only different types of civilization, but they 
also have reached different degrees of advance. It is 
unnecessary here to analyze fully the citizenry of our 
country. An illustration or two will indicate the gen- 
eral argument: 

How racial differences affect the success of school 
training is evidenced by the studies on colored children. 
The report of Miss Blascoer on the colored school chil- 
dren in New York, which endeavors to be very fair and 



52 THE EXCEPTIONAL CHILD 

charitable to this class of pupils, shows that of 441 col- 
ored children individually studied, 104, or nearly one- 
fourth, were "exceptional," that is to say, according 
to her use of the term, specially reported by principals 
or teachers; or they were truants, or ungraded class 
pupils; 147 were in the so-called retarded group — of 
these, 89, or over 60 per cent (20 per cent, or one-fifth 
of the entire number studied), were truly backward, ac- 
cording to the tests used. Similar percentages have 
been found in other studies of the colored race, notably 
that of Howard W. Odum in the public schools of Phila- 
delphia. These findings do not preclude high scholastic 
attainments by individual members of the race. But as 
a race the American negro, mixed type as he is, is not 
book-minded, but industrial, and has a genius of his 
own which has yet to receive proper recognition in our 
educational system. 

To throw further light on this interesting problem 
the author will quote a few selected passages from 
Marion J. Mayo's investigation on the "Mental Capac- 
ity of the American Negro." Mayo says: "The contri- 
butions which the races have made to human progress 
and culture have differed greatly. . . . The history of 
civilization is the history of relatively few peoples. . . . 
Certainly a sufficient reason for differences in the degree 
of progress made by different human groups may often 
be found in geographic conditions, even were the capac- 
ity for inward response supposed to be the same. . . . 
To determine whether the races of men actually differ 
. . . amounts to determining whether or not they have 
arrived at the same level, not on the scale of culture, 
but on the scale of organic and mental evolution. . . . 
The fact that the attention of a people is directed and 



DIFFERENT CIVILIZATION LEVELS 53 

engaged along certain lines, while in a way due to acci- 
dent, is not unrelated to its inward capacity for re- 
sponse. . . ." Statements of this kind, based as they 
are upon careful scientific research, are significant also 
when we judge the mooted question of "normality." 
This point will be discussed in a later chapter. 

Speaking of his results in studying the scholastic at- 
tainments of colored children in comparison with those 
of white children, he admits the same facts which Miss 
Blascoer has shown. He comes to the conclusion that 
the superiority of the white children "is due to a real 
difference in the general mental equipment of the two races 
— a difference that has been brought about through 
physiological and mental evolution, and which never 
can be equalized by processes of education and training." 
This difference is, however, much smaller than many 
have supposed. "But another factor which may be of 
greater significance for the social progress and intellec- 
tual capabilities of a race is its intellectual variability. 
The capacity of a race for independent progress depends 
in a very large measure upon its capacity to produce in 
considerable numbers men of very high ability. It is 
the man of genius upon whom social progress has ever 
depended. . . . Now, the greater the inherent varia- 
bility of a race in mental qualities, the greater will be 
its chances of producing men of that order of ability 
ranked as genius. Hence it follows that the capabilities 
of a race are to be judged less by the average ability of 
its members than by the limits of its hereditary varia- 
tion from this average, and the consequent number of 
its men of high ability." Professor Mayo then shows 
that "as regards mental variability, the white race is 
more variable, but not a great deal more variable, than 



54 THE EXCEPTIONAL CHILD 

is the negro race. But the importance of small differ- 
ences in hereditary traits is not to be overlooked. In 
the struggle for supremacy or survival, these small differ- 
ences may be, and no doubt often are, the determining 
factor." These conclusions, while opening up to the 
colored race welcome opportunities for future advance, 
nevertheless show the distinct difference of type. 

The American negro is no longer a separate people. 
But there are entire peoples and races which are back- 
ward as compared with modern civilization, and which, 
either in our possessions, or as immigrants, form part of 
our educational problem. They constitute the "white 
man's burden." There are not only those who have 
never created a special civilization of their own before 
the white race took them in tow, like the Filipinos, the 
South Sea Islanders, etc. But even nations which in 
ancient times were banner-bearers of civilization have 
stood still and become stagnant. The Persians plough 
their land to this day as they did in the time of Abra- 
ham, and the great masses of the Chinese live their life 
in modern times as primitively as did their ancestors in 
antiquity. The trend of history has often thrown peo- 
ples into cultural eddies, so to speak, after they had 
played their part at certain periods. Thus the Balkan 
states, the bone of contention between various great 
powers, have been left in a state of mediaeval semiciv- 
ilization the crudity of which has become sadly apparent 
in the wars of late years. 

Primitive Conduct. — As has been indicated before, the 
development of culture and civilization is brought about 
by the process of mental and social maturing. At the 
lower stage impulses release actions by direct reflex; 
with the development of the higher brain centres thought 



DIFFERENT CIVILIZATION LEVELS 55 

intervenes between impulse and reaction. The more 
completely reaction is controlled, and eventually inhib- 
ited, by thought, the higher is the stage of mental and 
social development. Thought has been fitly called 
"suppressed" or "suspended" action. Physio-psycho- 
logically expressed, the difference between modern civ- 
ilized man and the man of primitive or atavistic type is 
this: that with the latter the lower brain centres pre- 
dominate, producing reflex activity, while civilized man 
interposes thought and inhibition. So-called "panics" 
or mob-rule would indicate that either this mob is com- 
posed of men of primitive culture levels, or that through 
some strong and contagious affect, like fear, fright, pas- 
sion, the higher brain centres of the mass have become 
paralyzed for the time. Wars produce a similar effect 
upon the fighting multitudes and their contemporaries, 
lowering the civilization levels of the warring nations by 
centuries, whatever the sobering and stimulating influ- 
ence of war may otherwise be thought to be. 

Sometimes we observe, even in quite intelligent people, 
a certain adventuresomeness, a desire to live different 
lives, to tear themselves away from their accustomed 
surroundings, which have become irksome to them. Chil- 
dren show a similar desire to change their character; 
girls want to be boys, boys want to be girls; or they run 
away from home and school to live a less restricted or 
less tedious life. In some of these personalities we may 
be confronted with a permanent, latent psychic weak- 
ness which becomes acute under the stress of certain 
harassing emotions. The soul of man, after all, is not 
a perfect unit, but is composed of a great number of 
smaller psychic units which do not always harmonize. 

There are also temporary disorders of a psychopathic 



56 THE EXCEPTIONAL CHILD 

character which may affect individuals as well as masses. 
Relapses into primitive promptings and modes of action 
may be observed in civilized man under the effect of 
fatigue, or disease, or emotion, such as will temporarily 
weaken or paralyze the higher brain centres. Specific 
causes are drugs, digestive disturbances, irritations of 
various kinds, and intoxication. Most of us may, 
under such circumstances, have felt promptings to act 
irrationally; and if we are honest with ourselves we shall 
remember many a moment in our lives when we have 
come dangerously near to committing an evil act, even 
a "crime." The passionate desire to escape the con- 
fines of our present every-day life and environment, of 
our customary self, by running away, or even by suicide, 
may have been present in our soul often enough. 

Civilization Levels and Democracy. — As has been 
shown before in these pages, we are now witnessing an 
enormously rapid advance in life demands as character- 
istic of modern civilization ; a world-wide competition of 
peoples who, though far distant, have been brought near 
to each other by present-day means of travel and com- 
munication ; a condition of acute mental stimulation and 
unrest caused by these stirring changes — coupled with 
the development of democratic forms of government 
which have increased the social responsibility of the 
individual. This advance has made it particularly diffi- 
cult for the backward types and culture levels to become 
assimilated, and to maintain their existence and integ- 
rity in the fierce struggle of the millions for life and the 
pursuit of happiness. Occasionally they remain un- 
assimilated, like foreign bodies in the national organism, 
and become inimical to its life and health. 

This is true even for the backward types of our "na- 



DIFFERENT CIVILIZATION LEVELS 57 

tive Americans." It is doubly true for the backward 
types of our immigrants. Vast numbers of these mil- 
lions of foreign birth are to be quickly "Americanized," 
as it is styled. Closer analysis will reveal the fact that 
this process is largely superficial, confined to a modicum 
of language attainment, and that it will require the life 
of generations and a new articulation of ideas and ideals 
before these masses will fully enter into the inheritance 
of culture and liberal institutions of which the true 
American type is the expression; or before they will be 
able to give their own best racial contribution to the 
building up of progressive Americanism. The American 
type, at its best, represents a conservation and blending of 
all positive culture elements which the highest types of 
modern nations have developed. 

This, again, is a process of maturing, not merely of 
external coalescence. But America has certainly the 
peculiar advantage to secure a world-culture the like of 
which has never existed before, not even at the time of 
the Roman Empire. With it goes the high duty of 
steering free of race-prejudice and narrow-minded pro- 
vincialism, of the dominating influence of ephemeral 
fads and a mere mechanical majority-rule. True Ameri- 
can democracy must not produce and strive for averages 
on a level of mediocrity. It must recognize and en- 
courage variations. It must be built upon absolute re- 
spect for individual rights, as well as upon the principle 
of strict individual accountability. 

This true Americanism is a matter of healthy growth. 
The conditions of this growth are determined in the 
schools, the family life, the spirit of the body social. To 
secure it we must begin with the child. In the child all 
the difficulties alluded to in these opening chapters pre- 



58 THE EXCEPTIONAL CHILD 

sent themselves in their simplest terms and under con- 
ditions which may enable us to forestall antisocial de- 
railments. 

Individual Adjustment. — Efficient civic service 
through individual adjustment is determined by several 
important factors which will be understood in the light 
of this argument. 

The first factor is the position of the individual in the 
cultural scale. To what culture or civilization level does 
he belong? Is he one of a group, or stratum, or race, 
exhibiting primitive or backward elements? What is 
the cause of this group backwardness ? Is it due to his- 
torical, or political, or social influences and conditions? 
Is it of recent origin and localized, or is it dating back 
to ancient periods, a survival of savage instincts and 
bygone modes of life? Or is he a single individual, 
"born short," that is to say: Is he an atavistic type 
from causes which affected him alone ? What, then, in 
his hereditary endowment and his congenital affections 
must be held responsible for his condition, and to what 
extent can it be relieved ? Or is he the victim of social 
oppression, of economic pressure? Does he belong to 
the submerged? 

Again, if he is not altogether "born short" but has 
really all normal potentials, showing, however, at a 
given time tendencies of a primordial character: What 
is it that causes these phenomena of retroversion and 
reversion? Is there a psychopathic condition which 
needs diagnosis ? Can it be relieved ? Is he a "psycho- 
pathic personality," or merely the victim of temporary 
neurotic disturbance ? Or may he be acting under some 
great emotional stress? Is he one of a group, or social 
layer, collectively affected by some temporary emotional 



DIFFERENT CIVILIZATION LEVELS 59 

state — depression, despair, fear, fright, furor, panic, 
etc.? 

It is evident that individual adjustment will depend 
very largely upon the proper recognition and regulated 
training which each individual receives during the period 
of his childhood. 

We are now prepared to discuss the tentative classifi- 
cation of children presented by the author some years 
ago — a classification which is in reality a recognition of 
social strata such as has been suggested in this chapter. 



CHAPTER IV 
CLASSIFICATION AND TERMINOLOGY 

Traditional Confusion in Terminology. — Owing to the 
indefinite and arbitrary use of terms applied to the dif- 
ferent kinds and classes of children, and to lack of sci- 
entific perspective in determining the relation of devia- 
tions from normal standards, no full recognition of the 
real problem of the exceptional child has been possible. 
From this haziness and vagueness of terminology and 
classification much confusion has resulted even in ap- 
preciating the position and problems of normal and 
typical children. To obviate this the author has sub- 
mitted a tentative classification as a working basis. It 
was first elaborated in cruder form in 1902, and has since 
been enlarged and developed. The form here presented 
is a modification of the one which was submitted to the 
American Academy of Medicine, at its Atlantic City 
meeting in May, 1909. While it was first intended to 
give merely a clearer perspective of the problem of ex- 
ceptional development, it is really a review of the child 
problem in general, and presents in tabular form social 
strata, culture levels, efficiency types, etc., such as 
result from human endowments and opportunities. 

Classification 

A . NORMAL CHILDREN. 1 (Those who are in accord with the norm, 
or standard, of human nature, possessing all human potentials.) 

1 Standard Dictionary: Norm: A rule or authoritative standard. Nor- 
mal: According to an established law or principle; conformed to a type 
or standard; regular or natural. 

60 



CLASSIFICATION AND TERMINOLOGY 61 

i. Typical Children. 1 (Those who conform to the present stage of 
civilization, representing various racial, national, and individual 
efficiency types.) 
Variation of Types : Sex types, national and race types, civilization 
levels, temperamental types, vocational types, cultural types, 
civic types, etc. 

2. Pseudoatypical (Paratypical) Children. (Those who only 

seemingly deviate from type.) 

(a) Children Whose Progress in School Was Hindered by : 
i . Change of schools. 

2. Slower rate of development, without atypical or abnormal 

retardation. 

3. Temporary illness. 

4. Slight physical difficulties, such as lameness and minor 

deformities, slightly impaired vision and hearing, ade- 
noid vegetations, etc. 

(b) Children of Unusually Rapid Development, without genuine 

(pathological) precocity. 

(c) Children Difficult of Management: Mismanaged, troublesome, 

spoiled, "naughty" children, without nervous difficulty or 
genuine perversity. 
{d) Neglected Children: Those whose type fails of recognition, or 
who suffer from bad environment. 
Pseudoatypical children may be rapidly restored to normal equilibrium, 
or made effective in their own right, by proper provisions. 

3. Atypical Children. (Those who deviate from type, pathologi- 

cally, through impairment, without loss of the normal poten- 
tials.) 
(a) Neurotic, Neurasthenic, Psychopathic Children: Overstimu- 
lation and precocity. Genius. Psychopathic personali- 
ties. Irritability. Excessive imagination and lack of 
mental and emotional poise. Hysteria. Lack of concen- 
tration. Negativism; contrariness. Perverse tendencies. 
Sexual precocity. Fears and obsessions. Defective in- 
hibition. Tic. Motor disturbances. Vasomotor, sensory, 
and trophic disturbances. 
This class must be distinguished from that group of Abnormal 
Children whose mental defect is in the form of well-defined 
congenital psychosis. 

1 Standard Dictionary: Type: One of a class or group of objects that 
embodies the characteristics of the group or class; an example, model, 
representative, or pattern, as of an age, a school, or a stage of civilization. 
Typical : Having the nature or character of a type. 



62 THE EXCEPTIONAL CHILD 

(b) Children of Pathologically Retarded Development: Impaired 
conceptual ability due to retarded brain development. 
Physiological retardation of the growth rate. Special 
physical causes: chronic catarrh, chronic difficulties of 
nutrition, serious chronic affections of vision and hearing, 
venereal infection, etc. 
Any of these classes, through neglect or adverse environmental influ- 
ences, including faulty training, may drop down in the scale of develop- 
ment into lower classes. In other words, the individuals composing 
them may lose their normal potentials entirely and degenerate into per- 
manent defectiveness. On the other hand, starting out with normal 
potentials, atypical children may be helped to become efficient men and 
women. 

B. SUBNORMAL CHILDREN. 1 (Those whose potentials are incom- 
plete or permanently underdeveloped.) 
i. Physically Defective Children. (Congenital causes.) Blind, 
deaf, dumb, deformed, crippled, paralytic, and epileptic chil- 
dren. 
These children, although many of them are capable of maintaining an 
independent life and of attaining high efficiency within their limits, can 
never reach the perfect norm of human nature as long as their potentials 
are incomplete. 

2. Children of Arrested Development. (Acquired abnormal- 
ity or defectiveness.) 
(a) Pathological Classes: Children born apparently normal, but 
having their development checked at some period by: 
i. Hereditary causes, manifesting themselves at certain 

growth periods. 
2. Special causes, as disease, fright, accident, etc. 
This pathological arrest of development may be only par- 
tial, as in the case of children deformed by accident; 
then there will be only a condition of incompleteness, 
as in Group i of the Physically Defective Children; or it 
may be general, paralyzing mental and physical growth 
altogether. 

^he Standard Dictionary confuses "subnormal" and "abnormal." 
The Century Dictionary and Cyclopaedia, however, defines "subnormal" 
as "less than normal; abnormal by defect or deficiency." This is in 
line with the author's use of the word, especially when we consult the 
definitions of other words having the prefix "sub" in the same diction- 
ary. "Subnude," e. g., the word following "subnormal," is defined as 
"almost naked." In the same manner "subnormal" may be defined 
as "almost normal," lacking certain potentials which constitutes a defect. 



CLASSIFICATION AND TERMINOLOGY 63 

(b) Submerged Classes: Environmental influences have prevented 
them from attaining full maturity. (Stunted physical and 
mental growth.) 
Children of arrested development will remain essentially subnormal, 
no matter how well they be educated, or trained, within their limits. 

3. Children of Rudimentary or Atavistic Development: The 
primitive type, representing mental, moral, and social instincts 
and activities on the savage, barbarian, or more or less un- 
civilized level. 
Primitive Races. Atavistic Individuals. Atavism approaches the 
abnormal level. Atavistic individuals represent a reversion of 
instincts and capacities in spite of their birth from apparently 
normal parents, through hereditary or congenital causes. 
This class constitutes the fringe of human society. 
Groups A and B Compose Human Society. 

C. ABNORMAL CHILDREN. 1 (Those who deviate from the norm, or 
standard, of human nature.) Cretins, cretinoids; microcephalics, 
macrocephalics, hydrocephalics; idiots, imbeciles, feeble-minded; 
moral imbeciles and moral perverts; insane. Unfinished chil- 
dren. 
Abnormal children stand outside of human society and cannot 
maintain an independent existence. 

The diagram presented on next page will assist in un- 
derstanding the argument of this chapter. 

In studying this diagram and classification the follow- 
ing points may need further elucidation: 

Limitations of Classification. — No classification can 
differentiate definitely all individuals. An absolute 
classification is an impossibility. There are types so 
unstable that they present varying characteristics at 
different times, and others which exhibit combinations of 
traits. Thus, we find blind children who are also feeble- 
minded, or geniuses ; and neurotic children who have 
bodily deformities. There is a large assortment of 
mixed types. Besides, our knowledge of conditions of 

1 Standard Dictionary : A bnormal : Deviating from the natural struc- 
ture, condition, or course; unnatural. 



64 



THE EXCEPTIONAL CHILD 



DIAGRAM OF SOCIAL STRATA 

ACCOMPANYING A CLASSIFICATION 

OF EXCEPTIONAL CHILDREN 



.4§^t^^ 




V >OF 



humnn 



Fig. 2. 



child life is still quite limited, and we can do nothing 
more than present tentative measures. 

Normality. — In regard to normality, we may have to 
be satisfied to a certain degree with axiomatic state- 
ments, like the axioms upon which mathematical science 
is based. Yet, in the following chapter an attempt will 
be made to define normality in positive terms, and cog- 



CLASSIFICATION AND TERMINOLOGY 65 

nizance will be taken of the fact that the term "normal- 
ity" does not signify only one strictly circumscribed 
thing. The normal child in particular is a different being 
at different periods of his development, and normally so. 
Remembering the " culture-epoch theory" as outlined on 
pages 40 and 41, we shall readily see that there are nor- 
mal changes obtaining in a child's development from in- 
fancy to maturity. In a manner, the child passes from 
the primitive type referred to under B, 3, of the fore- 
going classification, through a series of stages to modern 
normal efficiency. In the third of the developmental 
periods as distinguished by the author, "the human 
species differentiates itself, in the rising consciousness of 
each young scion of the common stock, into racial 
groups, differing from one another in consequence of 
influences that shaped the various primitive types. 
These racial differences are deeply ingrained in the souls 
of the children, and manifest themselves in the order of 
their natural succession. . . ." At the end of this 
period "sexual differentiation in the physical life and in 
interest sets in." In the fourth period, with the begin- 
ning of puberty, "the national spirit is born. There is 
now a maximum of life intensity. . . . Control and in- 
hibition evolve; thought is born — real thought. . . . 
Gradually the child awakes to independent thinking and 
logical reasoning. The individual attitude arises, often 
with much overconfident self-assertion, in opposition to 
heretofore recognized standards. At the same time 
changes are noticeable which bring to light latent he- 
redities of family traits. . . . We have, then, this se- 
quence of developmental stages: species, race, nation, 
family, individual." 1 

If this development is unduly retarded or accelerated, 
1 "The Career of the Child," pp. 94/. 



66 THE EXCEPTIONAL CHILD 

we may be warned that there is danger ahead. Subnor- 
mality and abnormality in some of their types are caused 
by arrest of development at an earlier developmental 
stage. (Cf. Groups B, 2 and 3, and C.) 

Normality implies the presence of all human potentials 
in the individual. These potentials are physical, men- 
tal, moral, emotional, volitional, in character. The 
typical normal child must have all his sense-organs in 
serviceable working order; he must have a normally 
functioning body as to digestion and assimilation, and 
the metabolic process in general; his nervous system and 
his brain activity must be well balanced. Completeness 
of potentials is the first condition of normality. 

Potentially Normal Children. — Deviations from the 
normal standard through modification of type, or even 
through impairment of some potentials, do not invari- 
ably imply a corresponding decrease of usefulness for 
human progress. Quite the contrary. Even subnormal 
children, like blind and crippled, may grow up to be 
benefactors of mankind. There is the neurotic group 
which has furnished leaders of our race: poets, thinkers, 
inventors, patriots, enthusiasts. It is often a matter of 
circumstances; that is to say, environmental causes will 
determine which way the pendulum will swing — which 
way the potentials of an individual will gravitate. Here 
it is that family, school, and community forces will be 
determining factors. Here is the parting of the ways: 
one will lead to safe-breaking, the other to safe-making. 
The poet and the falsifier do practically the same thing 
— only from different motives. It has been said of a 
great surgeon that he had the instincts of a torturer and 
murderer turned to salutary account. The potentials of 
an individual are, morally and socially speaking, of a 



CLASSIFICATION AND TERMINOLOGY 67 

neutral character. Higher efficiency in the sense of 
modern citizenship involves thought and motive — asso- 
ciations which will direct the individual potency along 
distinct lines of expression. This expression may be 
socially constructive, or a-social, even antisocial, de- 
structive, negative. Thus, the genius and the crank 
may have the same potency — contrarily directed by the 
controlling forces of motive and judgment. It is not 
enough that there are active higher brain centres, that 
there is thought inhibiting reflex activity; thought and 
judgment must be socialized in the sense of community 
organization. 

Subnormality and Abnormality. — Any child who is not 
conforming to an assumed type of "normality" is often 
loosely called "subnormal," and the term "abnormal" 
is equally indiscriminately used. The author has taken 
pains to distinguish the truly abnormal child in definite 
terms. The term "subnormal" is carefully restricted 
to that group of children which represents limited, or 
incomplete, normality, but not abnormality. An abnor- 
mal child can have no efficiency in the sense defined in 
Chapter II; he can have only skill and training in skill. 
Many subnormal children, however, in spite of their 
limitations, may develop a very large degree of efficiency 
on a high performance level, as independent, self-direct- 
ing human individuals. Abnormal children, or at least 
some of the abnormal types, like the idiots and imbeciles, 
represent as it were an "unfinished" condition — unfin- 
ished in fcetal development. 

It will be noticed that the term "mental defective" 
has not been used at all in this classification. The reason 
is obvious to any one who has followed the author's 
argument so far. The term is vague and means nothing 



68 THE EXCEPTIONAL CHILD 

definite. Sometimes a distinction has been made be- 
tween a mental defective and an individual with mental 
defects; meaning that the former is defective right 
through, and the other has defects in restricted areas. 
The distinction is clever but does not solve the difficulty. 
For the "mentally defective" class, as thus discrimi- 
nated, the term "abnormal" is clearer in a scheme of 
graded terminology. On the other hand, we can hardly 
feel justified in grouping individuals with mental defects 
in a special class. For when it comes to a close analy- 
sis, every one of us has some mental defect, that is to 
say, is inefficient along one or several lines, and natively 
so. Especially if we take school requirements for a 
standard, we shall find very few individuals who are not 
"defective" in some way. 

The vagueness of the traditional terms "subnormal" 
and "mentally defective" becomes evident when we 
compare some of the definitions offered. The author 
refers to the many attempts made in circulars of school 
officers, training-school bulletins, and the like, to give 
some description of the classes of children for whom 
special provisions are made or contemplated. A recent 
statement of this kind is contained in an otherwise 
very meritorious study of truancy, by the field-worker 
of the Committee on Hygiene of School Children of the 
Public Education Association, New York, of which the 
author is himself a member. The mental normality of 
the truants studied had been "determined" first by the 
use of the delusory Binet Tests, which will be discussed 
in a later chapter of this book; the results of these tests 
"were verified by school records, family histories, and 
opinions of teachers and principals familiar with the 
children." The report claims that 43 per cent of all the 



CLASSIFICATION AND TERMINOLOGY 69 

150 cases studied were actually feeble-minded and 8 per 
cent were border-line cases. Then it says: "One of the 
salient characteristics of the mental defective is never 
to do anything regularly and on time except through 
training and habit formation or from outside compulsion. 
A methodical and well-ordered life is essentially the 
product of a normal mind." This view is so obviously 
one-sided that it hardly needs detailed discussion; or, 
rather, the obvious is usually most difficult to explain. 
But if this definition were true the insufferable pedant 
who is so methodical that everything goes by clockwork, 
and that the least disturbance of his minute regularity 
disturbs the even temper of his mind, would be the acme 
of perfection, the prototype of normality; while the un- 
fortunate poet or artist, with his happy-go-lucky Bo- 
hemianism, would have to be set down as feeble-minded. 
As far as the author's own experience goes, "training 
and habit formation" are the keynote of all normal 
education. 

A Caution. — This classification is intended mainly for 
children, with particular reference to their school career. 
While it is applicable to adults also, and demonstrates 
social layers and civilization levels, there are certain 
qualifications to be borne in mind. Congenitally insane 
children, e. g., are plainly abnormal; insane adults may 
be the product of acquired disease, or of neglect of 
neurasthenic and psychopathic conditions in childhood. 
Such conditions are observed in the group of "atypical" 
children. Neurotic and neurasthenic children exhibit 
symptoms of unstable nervous, mental, and emotional 
equilibrium and may, through environmental causes, 
develop true psychoses, although perhaps only for a 
period of time and not permanently. 



70 THE EXCEPTIONAL CHILD 

No Rigidity of Types. — This classification does not 
imply rigidity of types. In this it departs fundamentally 
from some of the other attempts at classification. Meu- 
mann, e. g., distinguishes the following strictly rigid types: 

A. Feeble-Minded Children: B. Normal Children: 

i. Idiots i. Dull (below average) 

2. Imbeciles 2. Average 

3. Debiles (Morons) 3. Above average 

Among the normals he differentiates a number of 
types, according to their leading traits (physical, sen- 
sory, motor, memory, observational powers, attention, 
imagery, etc.). 

While, naturally, there are some types whose vari- 
ability is but slight and largely on the level of skill, and 
while it is also true that the abnormals, as such, and 
many of the subnormals, on the basis of present knowl- 
edge, can hardly be expected to change type, it must be 
admitted that further experiment and research work 
may lead to surprising discoveries. It has already been 
shown that operative measures, in relieving pressure on 
the brain, or irritation of the sexual organs, may change 
the character of a child essentially. Weak-mindedness 
caused by syphilitic infection has yielded to specific 
treatment in recorded cases. The study of the secre- 
tions of the ductless glands has given opportunity for 
interesting experiments with low-grade children. Blind- 
ness and deafness have been cured. 

The function of training must not be overlooked. 
Proper education will go beyond the mere limit of skill 
and performance levels. It may elevate the volitional 
and emotional elements of the mind. Judgment and 
motive may be developed; primitive instincts may be 



CLASSIFICATION AND TERMINOLOGY 71 

brought under the influence of higher associations. 
Meumann's very terminology is so vague, especially as 
far as his "normal" children are concerned, that there 
is a wide margin for variation. 

We must concede that, within certain limits, indi- 
viduals of lower groups can be educated to higher grades. 
This is especially true of the normal group, which in- 
cludes the typical, pseudoatypical, and atypical children. 
The submerged classes as well as the representatives of 
rudimentary, primitive development may be gradually 
elevated to higher planes of civilized life. The solution 
of this latter problem cannot perhaps be hoped for within 
the life-span of an individual, but must be accomplished 
mainly by educational and social processes which extend 
through generations. 

There is also frequent backsliding or dropping down 
of individuals of higher groups into lower groups, through 
lack of education or opportunity, through illness, or 
through other unfavorable circumstances. Even typical 
children may lose their balance and be vitiated in some 
manner. 

The recognition of these two facts, of the ascending 
and the descending scale, means the stating of the grav- 
est and greatest of social problems. 

Terminology. — One word in regard to the terminology 
employed: ordinary dictionary definitions of the terms 
used in this classification are lacking in precision. It is 
therefore allowable to give the terms here suggested for 
designating the different groups a definite meaning and 
content. The term "atypical" has been in the past 
used mainly in biological terminology, also in morphol- 
ogy. Since first suggested in this classification, in 1902, 
it has been taken up by others and abused by some as a 



72 THE EXCEPTIONAL CHILD 

euphonic term for abnormal and mentally defective chil- 
dren. This is very unfortunate and really inexcusable. 

The Diagram. — Our diagram represents the circle, or 
compass, of human society. Outside the circle is the 
abnormal child — the non-human group, so to speak, the 
group of the socially inefficient. Abnormal children 
cannot enter the province of normal human activity and 
competition as self-directing members of society. Many 
may be made self-supporting, in a measure, as even 
domestic animals are, under guardianship; but they will 
require custodial care permanently. 

In the centre of the circle, as in the bull's-eye of a tar- 
get, representing the aim of human development, stands 
the complete, well-poised normal child of the twentieth 
century, the type of modern civilization. Within the 
limits of an average balance of potentials there is, of 
course, a great number of variations, each individual 
differing to some extent from the mathematical average, 
with excellencies and proportions of his own. But there 
is a sufficient natural poise to prevent eccentricity or 
derailment. When there is such a degree of disturbance 
of the normal equilibrium that the pendulum of reaction 
will not swing back in the proper measure, exceptionality 
begins. 

It is well to state here with particular emphasis 
that the "typical" child must not be confused with the 
"average" child. There is no such living being as an 
average child. Averages and means are mathematical 
computations derived from massing together a number 
of variations, and represent no actualities, except in 
terms of quantitative analysis for statistical purposes. 
In fact, the measure of progressiveness of any people is 
found in its variability from the average. Doctor C. S. 



CLASSIFICATION AND TERMINOLOGY 73 

Myers, in discussing the subject of differences on racial 
and sexual variability, makes the following important 
observation: 1 "A civilized community may not differ 
much from a primitive one in the mean or average of a 
given character, but the extreme deviations which it 
shows from that mean will be more numerous and more 
pronounced." 

A "typical" child in the sense the term is used in this 
classification is, in the first place, the normal child de- 
scribed in the following chapter, endowed with qualifi- 
cations commensurate to his age and to the develop- 
mental period his growth-rate warrants (unless this rate 
is exceptionally retarded or accelerated) . 2 But he is not 
only a normal child as such, irrespective of the century 
he lives in, but a modem child, distinct from the child of 
previous culture epochs in the development of his race. 
For each race of to-day this standard is more or less 
unlike. A typical American child of the present gener- 
ation is different from a typical Chinese, Japanese, 
Italian, Spanish, German, French, or English child of 
the same generation. This is one of the reasons why 
we cannot apply the same standards of mental measure- 
ment, or exactly the same methods of education, in dif- 
ferent countries or for different racial and civilization 
layers, without laying ourselves open to grave error. 
To exemplify: the transplantation of the "little red 
schoolhouse" of New England among the colored people 
of the South in the reconstruction period has damaged 
the colored children more than it has helped them. And 
"Montessori methods" and Binet Tests cannot be simply 

1 Quoted in Mayo's monograph on the American negro, referred to in 
the previous chapter. 

2 Cf. description of "culture epochs." 



74 THE EXCEPTIONAL CHILD 

imported for ready consumption by American communi- 
ties like French lingerie, a Havana cigar, or a bottle of 
Chianti. 

Each nation has a certain level on which the majority 
of its members will be found in intellectual and tem- 
peramental caliber and in social efficiency, as measured 
by national community demands. 

There are variations upward, downward, and sideways 
within the province of national normality. Mention will 
be made in the next chapter of the difference between 
the normal boy and the normal girl; this difference must 
also be recognized in the racial and national types. 
Then there are the differences in aptitudes and attitudes 
which constitute type variations in the matter of voca- 
tion, civic relations, and social endeavor. Within the 
type confines there may further be distinguished different 
grades of efficiency and performance levels, low, mediocre, 
and high, according to endowments. 

The concentric circles, or rings, of the diagram repre- 
sent the different layers, or strata, of human society. 
They indicate relative distances, or deviations, from the 
normal standard as exhibited by the child of normal 
balance. Neither the distances nor the areas shown 
here can be taken as indicating exact numerical propor- 
tions. But the farther a layer is removed from the cen- 
tre the greater is the deviation. 

Some of the deviations will not destroy but merely 
hazard the possibility of normal equilibrium. All those 
children whose deviations are not necessarily permanent 
are therefore still included in the normal group, repre- 
senting potential normality. They represent merely de- 
viations from type, apparent or genuine; not from the 
standard of human nature. 



CLASSIFICATION AND TERMINOLOGY 75 

It will be observed that from the rings comprising the 
pseudoatypical and the retarded groups loops extend 
into the inner circle of typical children. The meaning 
of this, of course, is that these groups represent the po- 
tential normality mentioned in the preceding paragraph, 
and that children of these groups may be brought in line 
with the typical group. Further, from the ring com- 
prising the neurotic group of atypical children, the loop 
extends into the very centre of the diagram. This centre 
represents genius: the individual of exceptional powers, 
Nietzsche's " Uebermensch " (superman), not altogether 
normal in the sense of an even equilibrium, but of tre- 
mendous importance for the progress of humanity — the 
most forceful variation. The author has avoided the 
use of the recently much-applied term, ''supernormal," 
which he considers self-contradictory: nothing can be 
more normal than normality, as there can be nothing 
whiter than white. In fact, the genius is a deviation 
from the normal, often pathologically so, paying for ex- 
ceptional brilliancy by sacrificing other normal faculties. 
According to the ancient French proverb, " Les extremes 
se touchent" (extremes touch), genius is related to insan- 
ity and even feeble-mindedness. Yet, it is also the ful- 
crum of human progress. 

The often amazing unconventionality of artists, their 
Bohemianism, their reck ess, happy-go-lucky conduct, 
remind one forcibly of primitive characteristics. The 
poet, the musician, the dreamer, the painter, the sculp- 
tor, the actor — all of them are closer to the elemental 
forces of human emotions, those that have come down 
to us from the beginning of the race, than the people 
who are bearing the burden of social repression; and 
they are often as irresponsible as children who, in their 



76 THE EXCEPTIONAL CHILD 

way, are less distant from the primordial instincts than 
the conventionalized adult. 

Each of the groups, or types, mentioned in this chap- 
ter will be discussed in this book. 



CHAPTER V 
THE NORMAL CHILD 

The Wail of the Well. — Attention has recently been 
concentrated so exclusively upon "mental defectives," 
" subnormals," "abnormals," and physically defective 
children, upon the consideration of social evils of all 
kinds, that the normal and the potentially normal chil- 
dren from whose ranks the sturdy citizenship of a nation 
is recruited, have failed of satisfaction of their just 
claims. Whatever did not fit into a preconceived sys- 
tem was branded as abnormal, so that the many varia- 
tions of normality remained undefined and unrecognized, 
and millions of normal children did not receive their due, 
becoming predestined for failure. The following witty 
little poem (published in the American School Board 
Journal) well expresses this ill-proportioned solicitude: 

"Johnny Jones has lost a leg, 
Fanny's deaf and dumb, 
Marie has epileptic fits, 
Tom's eyes are on the bum. 
Sadie stutters when she talks, 
Mabel has T. B., 
Morris is a splendid case 
Of imbecility. 
Billy Brown's a truant, 
And Harold is a thief, 
Teddy's parents gave him dope 
And so he came to grief. 
Gwendolin's a millionaire, 
Jerald is a fool; 

77 



78 THE EXCEPTIONAL CHILD 

So every one of these darned kids 

Goes to a special school. 

They've specially nice teachers, 

And special things to wear, 

And special time to play in, 

And a special kind of air. 

They've special lunches right in school, 

While I — it makes me wild ! — 

I haven't any specialties, 

I'm just a normal child." 

Definitions of Normality. — One shall look in vain in 
most treatises on "subnormal" and " defective" children 
for a clear statement of what normality consists in. 
More or less helpful definitions of various degrees and 
kinds of defectiveness have been given; the clearer, the 
farther away from normality the defect has taken the 
child. Thus, we are better informed about idiocy and 
imbecility than about normality. The definition of nor- 
mality was left to inference; we were supposed to make 
it by implication. Or, to put it in another way, we were 
supposed to reach a definition of normality by the proc- 
ess of elimination, that is to say, by enumerating what 
a normal child does not lack. Doctor Lightner Witmer, 
in a recent article, speaks of two " normality scales," (i) 
the deficiency scale, (2) the insanity scale. He says: U I 
have called these scales normality scales, rather than 
abnormality scales, because the study of the feeble- 
minded and the insane, whereby we establish different 
degrees of abnormality, is of less concern to the science 
of psychology than the study of so-called normal indi- 
viduals. For instance, we would like to know how many 
deficiencies an individual may exhibit and how unbal- 
anced he may be, and yet pass for normal." This nega- 
tive diagnosis does not satisfy Doctor Witmer himself, 



THE NORMAL CHILD 79 

and he promises a later contribution on these two nor- 
mality scales: (i) The sufficiency scale, and (2) the equi- 
librium scale. 

What is a Normal Child? — The terms "normal," 
"typical," "average," and many others of this kind have 
been loosely used to express what has never been fully 
denned. There are various axiomatic assumptions as 
to the meaning of the term "normality." One of the 
positive evidences of normality has been thought to be 
success in school. One has presupposed that there is a 
normal age for every school grade. If we assume, as is 
usually proposed, that the normal entrance age in the 
first grade is six years, the normal age for the second 
grade would be from seven to eight; in the third, from 
eight to nine, etc. On this basis a child would normally 
graduate from the grammar school at the age of four- 
teen. Any deviations from this scale would be "sub- 
normal," or "abnormal." If a boy of ten and one-half 
years who ought to be "normally" in the fifth grade, is 
found to be still in the second, he is called "three years 
below normal," or "three years over-age." The "nor- 
mal" child, on this supposition, goes to school in a regu- 
lar way, and at the regulation age. He learns to read 
and write after a fashion, also to add and subtract and 
multiply and divide. He learns something about the 
geography and history of the world and its peoples, is 
familiar with ordinary facts of nature, may learn to 
draw and paint and sew and hammer, and what not — 
to the delight of his teachers and parents. He will grow 
up to be an "average" workman or clerk or storekeeper; 
he may go to "high school" and "college"; he may be- 
come a merchant, minister, doctor, or politician, and 
make money, and have a position in this philistine world 



80 THE EXCEPTIONAL CHILD 

of ours. If it's a girl, she will be a housekeeper and 
homemaker of the traditional kind; or a professional in 
any one of the many fields of labor now open to women. 
At least, this is the assumption. 

School Success Not a Safe Standard. — Such a view 
of normality is based upon the assumption that school 
grades are a safe measure of intellectual caliber — which 
they are not. They are an artificial standard based 
upon efficiency, or even mere skill, in certain limited 
pursuits, like reading and writing. Average attain- 
ments are deceptive. A child who succeeds in passing 
ordinary requirements might be called a " conformist," 
one pursuing the course of least resistance, a mirror of 
circumstances. As a matter of fact, no one of the "or- 
dinary" children is an "average" child in all fields of 
activity. By giving the conformist a more thorough 
testing and opportunity, strengthening his will-power 
and self-confidence at the same time, we may find that 
he possesses hidden capacities which might, if properly 
recognized and trained, have made his life very differ- 
ent from the humdrum mediocrity to which he was con- 
demned. We shall discover that most of these children 
really represent very different types of mind, and that 
not any two of them are quite alike. The conformist 
is not necessarily a "normal" child at all — he may, for 
all we know, be even feeble-minded, or an extraordinary 
mixture of contradicting elements which invalidate each 
other. 

"Mental Age." — Another method of determining 
normality by positive means has been suggested by psy- 
chologists like Binet and Simon. After testing a large 
number of French children, these professors felt justified 
in establishing norms for a "scale of intelligence" which 



THE NORMAL CHILD 81 

was based upon the theory that normal children of a 
certain age must be able to meet certain performance 
tests. Thus, they proposed the idea of "normal mental 
age." In a later chapter this theory and the tests pro- 
posed by Binet and Simon will be further discussed. 
Here the author will only again quote from Witmer's 
previously mentioned article to show that this theory is 
not generally accepted. He says: "The Binet testers 
assume not only that they are testing intelligence, in 
which assumption they are mistaken, but also that they 
can employ one and the same test in order to distinguish 
the feeble-minded from the normal child, and to distin- 
guish the ten-year-old child, whose mental age is eight, 
from the ten-year-old child whose mental age is ten. 
Feeble-mindedness is not backwardness, although the 
feeble-minded child is undoubtedly backward. A ten- 
year-old feeble-minded child who has a ' mental age ' of 
six years is not at all like a normal child of six. The 
diagnosis of feeble-mindedness will be based upon more 
than the mere fact of four years' retardation. The per- 
formances of the feeble-minded are qualitatively and 
quantitatively different from the performances of nor- 
mal children." 

We need tests which will assist in diagnosing a child's 
mentality, and the second part of this book will treat of 
this method of investigation more fully. But the idea 
of "mental age" is an illusion if restricted to the chrono- 
logical standard, and if applied without consideration of 
difference of type. 

No " Average " Normality. — In endeavoring to de- 
termine what "normality" implies we must be very sure 
to understand that there is no such thing as "average" 
normality. An "average" is an arithmetical abstrac- 



82 THE EXCEPTIONAL CHILD 

tion; it has no existence in reality. Normal individuals 
may differ very widely in kind; they may even exhibit 
certain defects and difficulties without exposing them- 
selves to being branded as ''subnormal," or, indeed, 
" abnormal." Normality consists in certain positive as- 
sets of the individual which give him competency conditioned 
by a measure of human efficiency which will enable him 
to establish and maintain an honorable position in life 
and society. This competency may be potential only, 
and depend to a large degree upon opportunity for right 
training and self-manifestation, owing to the complex 
conditions of our modern life, as has been set forth in 
the previous chapters. But even potential normality is 
normality, and the incompetency may be that of the 
community, not that of the individual whom the com- 
munity fails to socialize. 

In the chapter on "The Feeble-Minded Group," the 
distinction between the abnormal and the normal child 
will be expressed in this way: that the latter possesses 
"common sense," the former does not. It is perhaps 
difficult to define "common sense" (which has been 
called "the most uncommon thing of all"), just as diffi- 
cult as it is to define normality. But every obvious 
thing is difficult to define. Yet we may. after all, 
arrive at some definite conclusions. 

Normality vs. Maturity. — A normal child is different 
from a normal adult in that he is immature from the 
standpoint of adult life, yet conforming to biological 
laws of growth which determine his development. 
Again, a normal man differs from a normal woman — a 
normal boy from a normal girl, in instincts, attitudes, 
capacities, methods of self-expression. Whatever we 
may think about woman's emancipation and competition 



THE NORMAL CHILD 83 

with man in public life, the sexual differences will never 
be eradicated, nor should they be. Any attempt to put 
the sexes on the plane of equality in kind, in compe- 
tency, in efficiency, will be fraught with danger. Their 
social functions will differ eternally — which does not 
imply, of course, that they have no interests and rights 
in common. Quite the contrary. But masculine nor- 
mality and feminine normality are certainly not identical. 
Said the Minneapolis Tribune wittily: "Boys have not 
reached that stage of civilization which afflicts girls. . . . 
Boys can be set to amuse themselves just as they could 
in more primitive times. Boys, indeed, offer a fixed 
standard of conduct which the mutabilities of thousands 
of years, including divergence of race and climatic con- 
ditions, have not been able to alter. We see the same 
characteristics in the boy of the slums, up to a certain 
age, that we do in the son of the millionaire. It is only 
when boys grow up that they yield to environment and 
habit. Here are some of the things common to every 
boy which civilization has not been able to affect: 

Every boy hates to be dressed up. 

Every boy will fight at the drop of the hat. 

Every boy hates girls. 

Every boy will lie to save himself from punishment. 

Every boy throws stones. 

Every boy says naughty words. 

Every boy will associate with any other boy he likes, regard- 
less of anything, such as money, position, etc. 

When, say, up to twelve, a boy does not conform to these 
rules, there is something the matter with him. Regarded from 
the standpoint of the other boys, he is 'no good.' " 

One must understand these things from the point of 
view of the "culture-epoch theory" as previously sub- 
mitted, to appreciate them in their right meaning. 



84 THE EXCEPTIONAL CHILD 

A girl is a very different creature, and cannot under- 
stand a boy at all. She is much more of a conformist 
than a boy. That is one of the reasons why under pres- 
ent school conditions girls are more successful and hap- 
pier in school than boys are. This success is helped 
along by the feminine atmosphere prevailing in our 
schools, owing to the predominance of female teachers. 
Because woman is so different from man, she will never 
fully understand the male attitude to life — and man is 
forever puzzled by the surprises he meets in the conduct 
of women. This is a contributory factor in the mis- 
understandings and frictions arising between the two 
sexes in grave questions of public concern, and in the 
unwholesome developments which occur when one or 
the other sex allows itself to be dominated by the other 
in social valuations which each sex must normally ap- 
proach from a different angle, and in which there will 
never be an absolute harmony of opinion and feeling. 
The "temperance" movement, the problems of prostitu- 
tion and crime, and others of this type, often exhibit 
these radical differences of attitude. 

An effeminate man is an abomination, and a mannish 
woman is an insult to womanhood. Likewise, while 
girls must be tomboys at a certain period of their lives, 
and boys will manifest girlish traits of primness and 
niceness after emerging from the " Flegeljahre " period 
(period of awkwardness and boorishness), these exhibi- 
tions will merely be indexes of transitions on the road 
to maturity. Were they to become permanent, they 
would indicate an abnormal arrest of development. For 
both boys and girls are very different, normally, at cer- 
tain different periods of their lives. 1 

1 Cf. "The Career of the Child," pp. 97/. 



THE NORMAL CHILD 85 

Racial Standards. — In addition to sexual differences, 
there is the difference in race and nation. Folk and race 
psychology reveals the distinctive traits which make a 
German a different being from a Frenchman, and which 
distinguish northern races from the Mediterranean type. 
There is such a thing as a "normal" Englishman as 
against a "normal" Italian. Sometimes one nation can- 
not understand another nation at all. Within the na- 
tions there are again differences of group normality, in 
accordance with the various civilization levels of which 
the author treated in Chapter III. In our own country 
the "normal" Southerner differs materially from the 
"normal" Yankee, and their lack of mutual understand- 
ing led fifty-seven years ago to the greatest crisis this 
land has ever passed through. 

Again, within the national confines, in the ordinary 
life of people, we are able to distinguish further types. 
Physiognomy and experience teach us to distinguish be- 
tween the workman and the scientist, between the school- 
teacher and the office girl, between the phlegmatic and 
the sanguine temperament. Each occupation is said to 
put its stamp upon its representative. This fact may 
be admitted, but we may be allowed to reverse cause 
and effect, and to believe, with Professor Mayo, that 
the choosing of an occupation may in itself be related to 
an individual's inward capacity for response; in other 
words, omitting conditions of environmental pressure or 
example, a different kind of man will select the profes- 
sion of teaching in preference to the occupation of black- 
smith, and this difference in type will appear in his out- 
ward characteristics. Studies of temperamental types, in- 
cluding the spendthrift as against the miser, the fanatic as 
against the reactionary, are leading in the same direction. 



86 THE EXCEPTIONAL CHILD 

Various Conditions of Normality. — There are, then, 
conditions of normality relating to sex, to age, to race 
and nationality, to occupation and type. Take the 
occupation of musician. We may assume a normal musi- 
cal type, the individual representing this type having 
the equipment of the true musical ear, of the perfect 
rhythm, of artistic conception, of absolute muscular con- 
trol in the matter of musical performance, etc. Another 
individual may lack some of these prerequisites, and 
therefore be a mediocre musician, perhaps only a skilful 
mechanical performer without musical creativeness, or 
utterly fail in this form of efficiency. But he may make 
an excellent physician, perchance with some musical 
taste. He embodies another type, for which there is 
another norm to which the normal musician cannot 
attain. This fact must be borne in mind in the matter 
of vocational training and guidance. 

It must never be forgotten that "normality" is not 
a single, simple thing. It implies many distinctly differ- 
ent things. 77 is of various kinds. There are, of course, 
individuals of no outspoken character, such as will do 
mediocre work in almost any department of human ac- 
tivity. There are the "conformists" who will readily 
fall into any groove. It is these who have sometimes 
furnished the standard of "average" normality. But 
their main characteristic is this very mediocrity, with a 
leaning toward philistinism. 

Efficiency and Normality. — It is unnecessary to speak 
again of "potential normality." The subject has been 
treated so fully before that no further argument would 
add anything essential. Details may be left to the 
treatment of special types in the following chapters. 

But those who have followed the argument at all will 



THE NORMAL CHILD 87 

now agree that normality is determined by individual 
competency. This competency is the result of individual 
efficiency — efficiency of such a degree that the individual 
may maintain his place in the environment to which he 
belongs, being able to meet all changes that may affect 
his environment. This will make him a "typical" rep- 
resentative of his time, age, and nation. 

He must possess a body of sufficient strength and 
health to meet emergencies without defeat; and a mind 
equally sane, so that it would not be thrown out of bal- 
ance under tension. He must possess initiative and cir- 
cumspection, the capacity for forethought and planning, 
for finding his place and understanding a situation. He 
must be able to learn from his own mistakes as well as 
from those of others. He must have resources which 
can be called forth in time of need. 

There must be a sufficient degree of plasticity and of 
capacity for growth so that the individual may adjust 
himself to community development. He must have 
stamina of energy which will make him a creative force 
in this process of social advancement; in other words, 
he must furnish his quota of efficiency increment. Skill 
alone is insufficient — even the lowest of beasts show skill 
in some things. 

Let us understand that these requirements do not 
imply in every instance a high performance level. We 
must not mistake the normality of a typical individual 
for the exceptional force of the leader. Leadership in- 
volves sublimated normality, so to speak. 

The efficiency of the normal individual may show 
itself in different directions. First, there is occupational 
efficiency, such as will give him and his family sustenance 
and security of life. Then, there is parental efficiency. 



88 THE EXCEPTIONAL CHILD 

As a parent he must be able to produce healthy, normal 
offspring, and to establish a sane, natural family life 
with all the educational elements of the home in proper 
working order. Thirdly, there must be social efficiency, 
that he may do his share as a unit in a community, in a 
political organism, as a citizen, as a human being, in his 
relations to his fellow citizens, his fellow men, the world 
at large. And, finally, there must be his own personal 
cultural efficiency, which ought to be commensurate to 
the culture level of his environment, and should also 
be of the expanding kind, so that he may be a factor in 
cultural advance. 

The same individual may not comprise within himself 
all these factors of efficiency, at least not in the same 
degree, and yet be a positive asset to his social setting, 
producing an efficiency increment which is distinctly 
measurable. He may lack public spirit, yet be a good 
father and a good business man; or he may be public- 
spirited without having much cultural efficiency. But 
the health of a nation depends upon the blending of 
these various types of efficiency among its citizens to 
make it efficient as a nation. 1 

1 An illustration of this fact is given in the Plainfield Courier-News of 
May 27, 1915, written, as is seen from the date, after Italy had entered 
into the European conflict, and by a man whose sympathies are strongly 
pro-English : 

"Whether the sympathies of Americans lean toward Germany or not, 
there is one strong point on which all can unite in giving Germany its 
due award of admiration. As an example of co-operation and organiza- 
tion in all lines of human endeavor for the advancement of their own 
country, Germans lead all nations. Only the most complete organiza- 
tion and disciplined mental attitude could have made such a stand 
against the odds which Germany is facing. ... A nation which can 
develop and perfect the details of such thorough organization and carry 
its commercial system to foreign lands cannot be ruined by even such 
disaster as Germany is now suffering, and will suffer in much greater 



THE NORMAL CHILD 89 

The ''potentially normal" types must be similarly 
organized in the manner described in Chapter II. Even 
the "subnormal" types can be articulated in a national 
system of efficiency, as has been shown in the previous 
chapter and will further be elucidated in the remaining 
chapters of this book. 

If this definition of normality is tenable, we shall 
understand better what a normal child is. A normal 
child must possess this same element of efficiency. But 
as a child's main function is to grow up in. & healthy 
fashion to be able to take his place in life, his main effi- 
ciency must be found in this very capacity for healthy 
growth, according to his special genius, to his special 
type. This capacity must never become arrested during 
the entire life of the individual. Anything that inter- 
feres with healthy growth, with the unfolding of the 
individual psyche, is a danger-signal. 

degree during recuperation. If defeated, Germany will settle down to 
business and energetically try to recover her standing among the nations. 
She will continue to give the world a lesson in the efficiency of organized 
and intelligently directed energy." 



CHAPTER VI 

POTENTIALLY NORMAL CHILDREN 

The previous chapters have endeavored to illustrate 
the problem of normality, and of normal competency 
and efficiency; as well as the general principles of devia- 
tions from the normal standard. It has also been shown 
that there is a considerable percentage of children whose 
educational success, and whose chances of reaching the 
level of efficiency for which they possess latent compe- 
tency, are endangered by various causes. Many of these 
causes are remediable, if promptly recognized; others 
predestine a child to more or less complete failure. It 
is therefore imperative for the educator to familiarize 
himself with the symptoms indicating danger, so that 
those children who possess potential normality, that is 
to say, those whose handicaps may be relieved, would 
have their chance. 

Pseudoatypical Children. — Among the potentially 
normal children the author has first enumerated the 
pseudoatypical or paratypical child. The classification 
submitted on pages 60 to 64 distinguishes several groups. 

Change of Schools. — The American school organiza- 
tion which leaves the administration of schools to State 
and local bodies, without any attempt at national equal- 
ization, is characterized by a considerable variation of 
standards. That is to say, a fourth grade in one place 
differs from one in another place, in requirements, pupil 
composition, teaching quality, etc. When a child moves 
with his parents to another district, even in the same 

90 



' POTENTIALLY NORMAL CHILDREN 91 

metropolitan community, or applies for admission to 
the school of an entirely different district, he is con- 
fronted with difficulties of adjustment if placed in the 
same school grade from which he migrated. His new 
class may be scholastically higher or lower, according 
to circumstances; rarely exactly alike. Adjustment, as 
classes and courses are organized now, is primarily a 
mechanical process in the matter of details of knowledge; 
thus, the common practice has been to consider the new- 
comer scholastically deficient, and to put him in a lower 
class. It would have been much wiser to consider rather 
his mental maturity and have him grapple with his prob- 
lems of adjustment on that basis. Some judicious 
coaching and special help will easily even out difficulties 
of this kind. 

Other Causes. — The pupil who has difficulties of ready 
adjustment to class standards in other ways is in many 
cases an equally simple problem, scholastically consid- 
ered. The child of slower mental and physical growth 
must be given more time and much encouragement, so 
that no stigma be attached to his tardiness. It is, of 
course, futile to expect all children to progress mentally 
at the same rate. Such a condition is just as impossible 
as to expect that the bodies of children should grow 
equally fast and to equal proportions. Every mother 
knows that she may have to buy ready-made clothes of 
the twelve-year-old size for her fourteen-year-old boy, 
or a fourteen-year-old size for her child of twelve. In a 
similar way minds grow at different rates. Some will 
grow faster than the average and others more slowly. 
The slower child is not necessarily deficient, or even 
lacking in talent and power. Some of our best minds 
were slow growers in childhood — like the slow-growing 



92 THE EXCEPTIONAL CHILD 

oak, which is a king among the short-lived minor trees. 
Among the "distinguished dunces" who gave their medi- 
ocre schoolmasters so much trouble while they were 
school children, may be enumerated such men as Web- 
ster (Case 4), Beecher (Case 5), Frbbel (Case 6), Linnaeus 
(Case 7), Volta (Case 8), Burns (Case 9), Balzac (Case 
10), Edison (Case 11), and Walter Scott (Case 12), all of 
whom were dullards in youth. 

Under the caption "Speed as An Element of Weak- 
ness," Doctor M. W. Van Denburg has contributed an 
investigation which he introduces by the scriptural quo- 
tation: "The race is not to the swift, nor the battle 
to the strong; . . . nor yet favor to men of skill; but 
time and chance happeneth to them all." Among other 
things he says in the course of his argument : 

If Charles Darwin (Case 13) were a pupil in one of our public 
schools to-day, the chances are nine out of ten, that he would be 
set down as a very commonplace, dull boy. His mind always 
moved slowly and with extreme caution from his earliest school- 
days. This was his individual constitution. 

If John Stuart Mill (Case 14) and Herbert Spencer (Case 15) 
were two boys in the same grade, Mill, who would be several 
years younger than Spencer — and who for a moment doubts that 
the brilliant, ready, quick-witted Mill would far outstrip the shy, 
nervous, plodding Spencer: the one would become a petted little 
pedant, and the other would be plunged into the deepest dis- 
couragement. These are not altogether fancy sketches. . . . 

Nothing is more certain in psychology than the vast differ- 
ence in the rate of speed at which different minds work. This 
is not at all a habit by any means. It is to a far greater degree 
an endowment. 

Suppose in public examinations as much time was given as is 
desired by each applicant, and thereby quiet of mind on this 
point assured. Suppose in school work the difference in natural 
endowment, in physical energy, in physical health, in previous 



POTENTIALLY NORMAL CHILDREN 93 

training, in home training, and, above all, the natural gait of the 
mind were taken into account in each case. Suppose accuracy, 
and reliability, and completeness of grasp, and sincerity of pur- 
pose were put in their proper places in estimating the value of 
work accomplished, the Darwins would not then always be set 
down as dunces, neither would the Mills so enormously outrank 
the Spencers. 

A child who has missed part of his school opportunity 
by illness or accident should be given all the help neces- 
sary to make up for his loss. It seems hardly in line 
with the general purpose of this book to devote much 
space here to these classes of seeming failure, as they are 
largely a matter of proper school administration. They 
are mentioned for the sake of completeness, and will 
again be referred to in the last part of the book, which 
is devoted to provisions for exceptional children. 

The same may be said of the cases of those children 
whose difficulty consists mainly in their unacquaintance 
with the language of the land to which their parents have 
emigrated; yet here the element of racial difference, in 
attitude, aptitude, temperament, historical tradition, 
civilization level, etc., enters gravely into the problem, 
so that their proper education is a much more complex 
matter than would appear on the surface. Of provisions 
for those who deviate from the type by the fact that 
they are unusually rapid growers, mention will be made 
in a succeeding chapter. Again, the neglected child, the 
undernourished child, the child whose home lacks the 
hygienic atmosphere, will be discussed later, in connec- 
tion with the other factors entering into their problem. 
It may simply be said here by way of parenthesis that 
the institution of school lunches, school baths, and school 
playgrounds, as well as of social centres, will work won- 



94 THE EXCEPTIONAL CHILD 

ders for this class of children; not to forget the helpful 
work of the neighborhood guilds and similar organiza- 
tions for social uplif t, provided they do not smack of smirk- 
ing charity, but are the expression of the consciousness of 
a social function and duty. 

Lack of Breadth in School Organization. — It is a dif- 
ferent matter when we discuss those children whose 
difficulty lies in the fact that the school does not reach 
them. This point has already been made clear in pre- 
ceding chapters. But it is very well for teachers and 
school administrators, as much as for parents, to become 
very certain in their minds as to the causes which may 
produce a child's difficulty in the school as such. He 
may belong to a type which is not yet recognized in our 
traditional courses of instruction. His case may reveal 
the fact that we need another kind of school organiza- 
tion. How these differences of type may be discovered, 
and what provisions should be made to eradicate present 
defects, will be set forth in the course of the discussion 
presented in this book. Here we are dealing with defects 
of the school, not of the child 

For all these children may not only be potentially 
normal, but altogether typical and complete as repre- 
sentatives of their type. Their failure in life would be 
due to maladjusted educational experiments made upon 
them. The wisdom and judgment of the educator are in 
question when all is told. Very few of us have as yet a 
clear knowledge of the physical and psychical life and 
evolution of the child, and faulty reaction on the part of 
the child may mean that we have handled him incor- 
rectly. The training of teachers is still a grave problem 
in our country, in spite of the fact that normal schools, 
teachers' colleges, and university courses in pedagogy are 



POTENTIALLY NORMAL CHILDREN 95 

being perfected more and more every year. Still we 
have only too many teachers of limited training and ex- 
perience; and often the tyros, those who have the least 
basic knowledge of the child mind, are placed in the kin- 
dergartens and primary classes where the foundations of 
mental work are laid. The mistakes made by these 
novices in teaching, in experimenting with the precious 
budding minds, are legion, and only too frequently warp 
a child's conception from the very start. 

Professional Training. — Teachers, however, do receive, 
at least in large numbers, some sort of professional train- 
ing. But parents are, as a rule, sadly deficient in such 
training, and often lack the wisdom of understanding 
and handling their children properly. Mothers' clubs are 
often mostly composed of women who have already made 
their fundamental mistakes with their own children ; and 
fathers 1 clubs there are none. A few attempts have been 
made to establish mothercraft schools, which so far are 
attended by an infinitesimal fraction of the prospective 
mothers of the land. The author has never heard of 
fathercraft schools. Thus a child's chance of being him- 
self, instead of being moulded according to the whims 
and prejudices and notions of his unenlightened elders, 
is very slim. 

No wonder, then, that we have so many children who 
are difficult of management — "naughty," troublesome, 
spoiled children. Some of them are troublesome because 
they do not know how to employ their perfectly normal 
and legitimate impulses and activities. A child is 
naughty to parents and teachers on the same principle 
that will make a gas-tank explode when touched with a 
burning match — it is the only natural method of response 
to a foolish method of approach ! 



96 THE EXCEPTIONAL CHILD 

Sense Defects. — When it comes to difficulties in the 
province of sense reactions, great caution is needed. De- 
fects of this nature are more common than is generally 
supposed; they are apt to escape attention, the children 
themselves hardly being conscious of having any defect; 
they have no criterion for comparison. A hard-of -hear- 
ing child learns the art of lip-reading almost instinctively, 
and is therefore producing, to himself and to others, the 
illusion of being able to hear. Many cases have come 
under the author's observation of children whose power 
to hear articulate speech was so greatly diminished that 
they were almost deaf; sometimes they were suspected 
of some slight defect in the matter of hearing, but as a 
rule both their parents and their teachers were abso- 
lutely amazed to learn of the extent of their infirmity 
after the application of proper tests. Children of defec- 
tive hearing and vision are often accused, unjustly, of 
course, of inattention, stubbornness, laziness, and back- 
wardness. 

Observational Attitude. — To be able to make a more 
detailed study of handicapped children we must first 
develop the observational attitude of the diagnostician, 
and train ourselves to consider everything we cannot 
readily explain as a symptom to be studied. For every 
symptom we must train ourselves to look for a cause. 
Proper observation implies a careful distinction between 
facts observed and the explanation we may give them. It 
is a very common error to substitute our interpretation of 
a fact for the fact itself, and thus records of children are 
often vitiated. To say: to-day the child was naughty, or 
annoying, or lazy, or what not, means nothing at all. 
Such a statement implies a foregone conclusion, a judg- 
ment, not a record of fact — unless of the fact that the 



POTENTIALLY NORMAL CHILDREN 97 

child's conduct affected the recorder in a certain manner. 
Manifestations on the part of the child which may be 
displeasing to us are not necessarily expressions of a 
child's evil genius or defectiveness. The entire idea of 
discipline and punishment is undergoing a change. Only 
one who can inspire the child with confidence and who 
puts the child under observation absolutely at his ease, 
will gather reliable data. 

Atypical Children. — The various groups of "atypical" 
children will be further discussed in the following chap- 
ters. Even with them, however, we may first empha- 
size the necessity of studying the sense-reactions of each 
child. The acuteness of the two principal senses of vision 
and hearing should be determined by the ordinary tests, 
which are so simple that the preliminary work can be 
done in any school or home. Eye-strain is frequently 
accompanied by headaches; chronic headache is there- 
fore a danger-signal. The other special senses — taste, 
smell, touch — not to speak of the muscular sense, the 
temperature sense, the sense of balance — rarely receive 
the attention they deserve. Yet we often find curious 
defects which may be considered as indicative of incom- 
plete potentials, and consequently of incomplete sensa- 
tion, making the sufferers really subnormal. If we re- 
member that under certain circumstances we may have 
to fall back upon one or more of these neglected senses, 
as in the cases of Laura Bridgman and Helen Keller, 
we may well be reminded of their importance. The 
sense of touch is, indeed, the most fundamental of all 
senses, from which the others have become differentiated 
in the process of evolution. 

Blind and Deaf Children. — Although belonging to the 
subnormal group, blind and deaf children may possess 



98 THE EXCEPTIONAL CHILD 

such other splendid mental and physical endowments 
that their competency is often considerable, and the 
efficiency increment they may contribute to social life 
and progress represents values as great as those of nor- 
mal children. They may therefore justly be mentioned 
in this connection. 

Real blindness and deafness are defects which deprive 
a child of potentials which are necessary for complete- 
ness of sense-perception and mental conception. For 
them some elements of human knowledge will forever be 
eliminated, at least in their direct bearing upon thought, 
and they will depend upon the experience of others along 
these lines of observation. These vicarious experiences 
must symbolize to them what can never be their own 
experience. For this reason the author has placed them 
in the subnormal group, as physically and physiologically 
defective, with a corresponding psychologic deprivation. 
This does, however, not imply at all that they are more 
prone to be also mentally defective than seeing and 
hearing children. Helen Keller (Case 16), whose case 
has demonstrated better than many another the won- 
derful possibilities of a mind which is deprived of both 
the seeing and the hearing paths to knowledge, wrote the 
author in a telling letter: 

I, too, was handicapped in the earliest years of my life. I, 
too, had a potentially normal mind. Strong barriers had to be 
broken down before my mind could be awakened and developed. 
Only the skill of a wise, loving teacher made this possible. 
Only a patient study and clear understanding of my mental 
needs lifted me up to a happier, freer existence. ... It is of 
the utmost importance to give every child the best education 
of which he is capable. No effort, no money, no sacrifice should 
be spared. The more severely a child is handicapped, the more 
precious is whatever equipment is given him for the struggle of 



POTENTIALLY NORMAL CHILDREN 99 

life. Let the public once realize how far such children can be 
helped, and nothing will be left undone to prevent the fearful 
waste of human minds which lies heavily upon our civilization. 
This is true conservation — the saving of valuable human facul- 
ties from neglect and unskilful teaching. 

The other groups of subnormal children will not be 
separately taken up here, as they are discussed in con- 
nection with causes and conditions of exceptional devel- 
opment in later chapters. But it seems to be the place 
here to call the readers' attention to some of the symp- 
toms which the educator must learn to observe, to secure 
timely recognition of DANGER-SIGNALS which would 
indicate that the normal development of a child is put 
at hazard. 

Principles of Growth. — Human life is determined by 
principles of growth and development; growth as to size 
and weight, and development as to organization, differ- 
entiation, and function. There is the size and weight of 
the body as a whole; there is the evolution of the bony 
skeleton, of the muscles and viscera, of the central and 
peripheral nervous system, with the "sympathetic" 
branch which regulates the functions of the viscera. 
Upon the growth and development of the nervous system 
depends the development of the functions of intellect 
and will. Abnormalities of growth and development are 
distinct danger-signals. There may be irregularities in 
the matter of growth periods. Anatomical growth may not 
keep pace with mental growth. By Crampton the help- 
ful distinction has been made between chronological, ana- 
tomical, physiological, and psychological growth, or age. 
Though he had years of life in mind, we may apply his 
distinction to the developmental periods upon which the 
author bases his analysis and argument. Mental pre- 



100 THE EXCEPTIONAL CHILD 

cocity may be unsupported by healthy development of 
physiological function; or physiological function, e. g., in 
the matter of sexual development, may be unaccompa- 
nied by the balancing power of mental maturity. Any 
such discrepancy will cause a tension fraught with 
danger. 

Body measurements and tests of physiologic function, 
together with repeated tests of mental growth, are of the 
utmost importance in the study of the individual child. 

Early Observations. — Some of the earliest observa- 
tions can and must be made by the parents. A child 
ought to smile not later than at the age of three months, 
sit up at four to six months of age, stand up at one year, 
and begin to walk and talk a little later. Whooping- 
cough at a tender age frequently injures a child men- 
tally, through mechanical lesion. Neurotic babies are 
subject to convulsions and thumb-sucking. The latter 
is also a sign of sexual danger in early infancy. Infec- 
tious diseases, like measles and scarlet fever, often leave 
their traces behind. 

Functional Defects. — Defective teeth are invariably a 
danger-signal. They may prove the existence of various 
functional diseases, hereditary or acquired (including 
syphilitic infection — "Hutchinson's teeth"), which pre- 
vent proper formation and growth; or they point to mal- 
nutrition, poor digestion (with the formation of decayed 
matter affecting the teeth, in solid, liquid, or gaseous 
form), and other temporary causes. In every instance 
they interfere with the proper mastication and digestion 
of food, with the protection of the nasal-pharyngeal cav- 
ity, with proper growth of the bones of the jaws and of 
other parts of the skull, and with proper articulation. 

Facts of respiration and heart action, of appetite and 



POTENTIALLY NORMAL CHILDREN 101 

digestion, of headaches and dizziness, enter into this 
group of observations. It has been found that the grip 
of the hand is a fair index of intellectual development, 
lower grades of mentality lacking the muscular control 
necessary to produce an effective grip. This proves, by 
the way, that even manual efficiency is a matter of men- 
tal control, even in seemingly simple activities. 

Frequent urination is a danger-signal. It means either 
distinct disease or lack of volitional control — in other 
words, a psychic difficulty. Regular examinations of the 
child's urine should be made for the detection of diseases 
of the kidneys, diabetes insipidus, intestinal intoxication, 
etc. There might also be examination of the blood for 
anaemia, leukemia, parasites (malaria), inflammatory 
states, infection (syphilis), etc.; also occasional tests of 
the fasces for ability to digest various foods, intestinal 
parasites, etc. 

The so-called "growing pains" of children are rather 
a suspicious element. They are often rheumatic in 
nature and require special attention. Rheumatism in 
childhood is dangerous for the reason of its insidious 
onset and never very acute manifestations. 1 

Left-Handedness. — Left-handedness has often been 
considered a danger-signal. It indicates, of course, a 
deviation from typical conditions. Right-handedness is 
a very ancient characteristic of the human race, and 
even primitive peoples are generally right-handed. Left- 
handedness is therefore a variation not to be considered 
as a primitive trait. As a matter of fact, left-handed in- 

1 Doctor J. A. Colliver has found that one of the earliest manifesta- 
tions of rheumatism on the nervous system is irritability, fretfulness, 
and the like. There seems to be a close relation between rheumatism and 
chorea. 



102 THE EXCEPTIONAL CHILD 

dividuals are found among the very intelligent and skil- 
ful; left-handedness as such is therefore not a danger- 
signal, unless it is coupled with other symptoms. It has 
been shown that the usual right-handedness may have 
one cause in the arrangement of the blood supply from 
the heart which favors the right arm; left-handedness 
would, then, indicate a reversion of this arrangement. 

Another cause of the right-handedness of the great 
majority of men, however, is the stronger development 
of the left hemisphere of the brain. When, therefore, 
left-handedness is associated with speech defects, as it 
often is, it would reinforce a diagnosis of defective cen- 
tral condition; for speech defects, unless caused by ana- 
tomical defects in the organs of speech, can be explained 
only by underdevelopment or lesion in the speech cen- 
tres of the left hemisphere. Speech defects are a grave 
danger-signal. 

Difficulties of the Nervous System. — Here we come to 
the extensive sphere of danger-signals in the develop- 
ment of the nervous system. This is at the same time 
the province of psychologic and mental disorders, in- 
cluding the fully developed psychoses. Yet it should 
never be forgotten that there is a constant interaction 
between bodily and psychic conditions, and that it is 
impossible to separate absolutely the psychical from the 
physical. Bodily symptoms will indicate psychic dis- 
orders, and psychic symptoms will point to disturbances 
of physiologic function. 

Some of the danger-signals in this province are changes 
in temperament (crying and laughing readily) and un- 
warranted attacks of temper; rapid fatiguing and disin- 
clination for effort; drowsiness, excitability, insomnia. 
There are the defects of memory and concentration; of 



POTENTIALLY NORMAL CHILDREN 103 

judgment; and in the sphere of will, lack of determina- 
tion and decision. A mechanical memory alone is not a 
sign of intelligence, and is found remarkably developed 
even among imbeciles. Precocity is another sign, even- 
tually of nervous strain and derangement. 

Apparent disinclination to obey may, as has been 
shown, be due to imperfect hearing; it may also be evi- 
dence of psychic disease, like "negativism." Aversion 
to reading and writing may be caused by imperfect 
vision; or it may be the effect of an impairment* of the 
speech centres in the brain (alexia and agraphia) . Ugli- 
ness and irritability may be traced to astigmatism, which 
in turn produces eye-strain and persistent headaches. 
Yet these symptoms may also be due to disturbances of 
digestion (trophic disturbances) or to nervous disorders. 
Laziness is often a symptom of anaemia or of neuras- 
thenia, of vasomotor disturbances; or it may be caused 
by malnutrition, overexertion at home, lack of sleep, 
or lack of ventilation in the child's sleeping chamber. 
Fretfulness may have its cause in a great number of 
various conditions, notably indigestion; it has its neuro- 
pathic aspect, also. We are tempted to feel very much 
vexed when a child makes grimaces, when he is inclined 
to giggle and babble, or to disturb the artificial discipline 
of the schoolroom by whispering. Yet these manifes- 
tations, when they are not perfectly natural expressions 
of a child's overflowing life intensity, as well as other 
symptoms, like sniffing, coughing, restlessness, and in- 
attention, may be, and often are, symptoms of nervous 
disease. They may be enumerated among the so-called 
habit-tics or habit-spasms, like twitching, shrugging, 
shuffling, grinning, sighing, yawning, echolalia (the repe- 
tition of words spoken by another, as, e. g. 6 repeating a 



104 THE EXCEPTIONAL CHILD 

question before answering it), uttering curious sounds, 
such as chirping, etc. Again, momentary inattention 
and absent-mindedness may be due to a mild form of 
petit mal (epilepsy). Sudden attacks of excitement, 
outbreaks of temper, destructiveness, hitting other chil- 
dren, and the like, suggest the presence of psychic epi- 
lepsy. There are manifold movements characteristic of 
chorea. Although true hysteria is a disease which does 
not develop before the adolescent age, there are quite 
a number of conditions in children which may be count- 
ed among hysterical symptoms. An emotional temper- 
ament is one of them; instability of will and irresponsi- 
bility are others. These symptoms are very often found 
in young girls who seem to be predisposed to develop 
true hysteria unless preventive measures are taken at 
the right time. It has been observed that an exagger- 
ated imagination and selfishness, or rather self-centred- 
ness, go with these symptoms; and that deviations 
from the truth and fabrications of often astounding con- 
sistency are characteristic of this condition. Children's 
lies are a chapter in themselves. Books have been 
written on the child as a witness, showing how unreliable 
the statements of children are, even of those who are 
generally truthful. A tendency to lie, to tell stories, is 
symptomatic of certain developmental periods. 

These statements show how necessary it is to observe 
children carefully. Practically all of those showing 
symptoms of the kind enumerated in the preceding para- 
graphs are potentially normal, but need the attention 
and care which will protect them from failure and de- 
struction. 

Retarded Brain Development. — In some children of 
the atypical class there is a pathologically retarded 



POTENTIALLY NORMAL CHILDREN 105 

growth rate which also affects brain development. 
These children show a retardation of mental develop- 
ment which has to be very minutely studied. The bud- 
ding-time of every faculty, every manifestation of new 
growth, every twist the mind takes in groping for further 
touch with the world of knowledge, every indication of 
power to do, must be taken cognizance of and must be 
utilized. These children are like a tender, slow-growing 
plant which the gardener cherishes with particular care. 
They will usually repay all this attention by later strong 
growth. If they fail, they may approach the condition 
of arrested development, like those of Group B, Sub- 
division 2, in the author's classification, or they will sink 
even lower in the scale of intellectual measure. Among 
them we shall find a great many of the "repeaters" 
mentioned in the beginning of this book. 



CHAPTER VII 

EXCEPTIONALLY BRIGHT CHILDREN 

We may distinguish four classes, or types, of excep- 
tionally bright children, using this term as meaning 
children who are in advance of their fellows of the same 
age, especially in school work. 

FOUR CLASSES OF EXCEPTIONALLY BRIGHT CHILDREN 

The first group consists of children endowed with a good 
memory. 

The second group comprises those whose physical and 
mental growth is generally more rapid than that of an 
ordinary child, without pathological precocity. 

The third group consists of children of one-sided devel- 
opment, i. e., having one faculty, or group of related fac- 
ulties, developed out of proportion to the other faculties. 

The fourth group is composed of those children in which 
special or general excellency is associated with neuropathic 
and psychopathic tension. 

The first two groups belong to the class of pseudo- 
atypical children; the last two groups represent atypical 
conditions. 

First Group: Children Endowed with Good Memory 

Success in school, as already shown, is not altogether 
an index of real mental excellence and efficiency. The 

106 



EXCEPTIONALLY BRIGHT CHILDREN J 07 

first group of "bright" children does not necessarily 
represent brightness or brilliancy at all. It simply rep- 
resents success, at least of a temporary kind. 

Their "good memory" is largely of a mechanical kind. 
In school work, which consists mainly of recitations and 
the acquirement of book knowledge, they are apt to 
make rapid progress through the grades. They "learn" 
because they retain the lessons and can reproduce them, 
as a sponge returns the water it has absorbed. There 
are, indeed, good minds lucky enough to be also endowed 
with a good memory, and weak minds whose weakness is 
augmented by a short memory span. But it does not 
infrequently happen that very mediocre or even feeble 
minds, through having a good although mechanical mem- 
ory, will outshine their betters in school work of the 
ordinary kind, before the higher reasoning faculties come 
very much into play. When that time comes they will 
be hopelessly left behind, much the worse for their 
"learning," which does not represent any live value to 
them ; its acquisition has prevented them from preparing 
themselves for life in their own lowly fashion. In their 
case it is a matter of early diagnosis to direct them along 
really educative lines. Their memory endowment will 
assist them in developing skill in certain lines of activity, 
but will not make them socially efficient in the sense of 
higher competency. 

The other three types involve intellectual faculties of an 
unusual character. 

Second Group: Children of Accelerated Physical and 
Mental Growth 

The pace of a child belonging to this group is faster, 
his process of maturing is hastened. He travels in an 



108 THE EXCEPTIONAL CHILD 

automobile when the others ride on horseback or travel 
on foot. He covers distances with lightning speed. 

There is the case of Robert Wiener (Case 17), whom 
his father, Professor Wiener, distinctly pronounces to be 
a perfectly normal boy. Robert Wiener graduated from 
Tufts College at the age of 13 years; at the age of 17 he 
took the degree of Ph.D. at Harvard, and then studied 
for two years at Cambridge University, England. He 
was appointed, at the age of 19, assistant professor of 
philosophy at Harvard College. 

Winifred Sackville Stoner, Jr. (Case 18), lately of Pitts- 
burg (now Wilmington, N. C), seems to belong to this 
class. She is perhaps an exaggerated type and has had 
unusual opportunities — the exclusive attention of a 
bright and well-educated mother, a good and well-cared- 
for home in which everything was sacrificed to the 
child, a sturdy heredity. 

From her chronological development a few data may 
be quoted: 

At 6 months: Could talk and knew colors. 

At 16 months: Could read. 

At 2 years: Wrote own name on hotel-registers and began 
keeping a diary. 

At 3 years: Amazed adults by her spelling. Acquired use of 
the typewriter as an aid to learning spelling and 
memorizing. 

At 4 years: Learned the Latin declensions and conjugations 
as singing exercises, and received a diploma in 
Esperanto. 

At £ years: Wrote stories and jingles for newspapers, spoke 
eight languages, translated " Mother Goose " 
rhymes into Esperanto, learned to waltz, two- 
step, and three-step. 

At 7 years: Learned the outlines of Greek, Roman, and Scan- 
dinavian mythology. 




Fig. 3. — Winifred Sackville Stoner, Jr., in eurhythmic pose. 



EXCEPTIONALLY BRIGHT CHILDREN 109 

At 9 years: Passed entrance-examinations to one of the largest 
Western universities. 

At 10 years: Was elected president of the Junior Peace League 
of America. 

At ii years: Began specializing in music, art, and dancing, con- 
tinuing her academic work and physical training. 

At 12 years: Ready for graduate work in any university in the 
country. 

Her mother, Mrs. James Buchanan Stoner, wrote to 
the author under date of June io, 19 15, from the United 
States Marine Hospital at Wilmington, N. C, as follows: 

Winifred is now in the adolescent period, and I am striving 
to guard her from undue excitement of either mental or physical 
nature. As you know, I am a firm believer in filling the child's 
mind full of good material for educational foundations during the 
memory period from 2 years to 12, and now that the reasoning 
period has begun she has something about which to reason. 

Winifred has no set lessons, but from early training she has 
become such a lover of good literature that she would be most 
unhappy if deprived for a single day of converse with her book 
companions. She reads at least for an hour each day. At pres- 
ent she is reading everything she can find about Japan, as she 
plans to write a play on this subject. For two hours she helps 
me as my secretary, answering letters, and working on "The 
Natural Educational Manual" and "Natural Educational Game 
Book," two books to be ready in fall. Winifred and I will be 
joint authors of these books, and another book belonging solely 
to the kiddie, and which she calls "Facts in Jingles," will be 
published by Bobbs-Merrill in a few weeks. Winifred has cor- 
rected proof of this book since returning from New York. 

She practises for perhaps an hour each day on both her violin 
and piano, and amuses herself playing for little colored children 
who live in cabins facing our reservation, playing for them on 
the mandolin, jew's-harp, or orchestra bells. 

One or two afternoons of each week she goes to the beach to 
swim, and on Wednesday evening she is allowed to attend a 
little dancing club until 9.30 p. m. 



110 THE EXCEPTIONAL CHILD 

Nearly every pleasant Saturday afternoon she goes with sev- 
eral friends of her age canoeing or botanizing. As you know, 
North Carolina is the home of some very interesting plants, 
among them the Venus fly-trap, bladderwort, pitcher-plant, and 
other carnivorous members of the plant family. Winifred is 
intensely interested in these plants and has sent specimens to a 
number of our friends in northern cities. 

Each morning she plays at least one game of tennis before 
breakfast, and after dinner in the evening she and I play croquet 
or take long walks through the white sandy tracts around our 
home. 

At least fifteen minutes is spent in the kitchen each day 
gaining knowledge of culinary matters, and yesterday Winifred 
made a skirt for herself. 

On one of our up-stairs porches I have a regular gymnasium, 
and here every afternoon, when we are at home, we exercise for 
at least one-half hour before taking a shower-bath and rub-down. 

The little girl has learned how to drive an automobile and 
occasionally I let her drive when we take motor-trips. She drives 
also her horse Coupon, and occasionally rides horseback. 

Some of her time is taken in training a menagerie of pets. 
We are trying our N. E. theory on all sorts of young things, and 
you will laugh at the mixture. In her pet house, which is a large 
screened tent, formerly used as a mess-room by some of our 
officers, Winifred has three baby rabbits, four kittens, two 
pigeons, two baby chickens, a baby catbird, a pup, and an alli- 
gator. I have always contended that any animals could be made 
to care for each other if they were raised together, and it is a won- 
derful sight to see the cats kiss the catbird and not hurt it. I 
am going to try to get a photo of the rabbits sleeping in their 
nest, the bird sitting on a small tree by the side of the kittens, 
and the chickens pecking peacefully at their plate of corn. A 
number of people are watching the outcome of Winifred's ex- 
periment with much interest and they predict that the kittens 
will eat the birds and chickens and rabbits. 

Winifred has a canary which she has tamed and taught to 
do many wonderful tricks, and while she writes her stories on 
the typewriter he sits on the carriage of the machine and sings 
to her. To-morrow she is to receive a monkey and poll-parrot 
from a sea-captain, and then you will believe that there will be 



EXCEPTIONALLY BRIGHT CHILDREN 111 

no time for study of books, as the pets will take up every spare 
moment. 

I am writing to you of these trivial matters so as to paint a 
picture of the simple, happy, full life Winifred leads at this 
chrysalis time of life, when no child must be forced to study or 
to play. 

The picture showing her in a eurhythmic pose with co-ordina- 
tion of mind and muscle is perhaps the best. . . . 

She is five feet and three inches tall, weighing 130 pounds. 1 
Although she does not look overfat and her flesh is very firm 
and solid, I am using tennis before breakfast to train off a few 
pounds, as I do not want her to be a heavy-weight champion. 

Up to the present time she has never been beaten by any 
boy of her age in any athletic match. 2 She is certainly a perfect 
specimen of physical health and strength, and Doctor O'Shea 
says that she knows more and can do more than the average 
college graduate. 

I am proud of her strong body and cheerful disposition, but 
most of all I rejoice in her lack of conceit. She does not think 
that she knows anything, and she always objects to showing off. 
She cares nothing for public applause, and during our last visit 
to New York she consented very unwillingly to help me on the 
stage. 

She is now to keep away from public life as much as possible 
for the next six years and see if she can grow up with the same 
unaffected manner and lack of conceit which has characterized 
her childhood days. 

It is certainly gratifying that Winifred has not paid 
the penalty of conceit for the great publicity which has 
been given her education and accomplishments. From 
the interesting statements of her mother it appears that 
the child had, at the time of this writing, not reached 
puberty, so that in the matter of the development of 
the most vital feminine function she is not as advanced 

1 These measurements are excessive. Tall girls of 14 or 15 reach that 
height, which is the mean for girls of 19 and 20. The weight exceeds 
that of the tallest girls of twenty by about five pounds. — M. P. E. G. 

2 No boy of her age can equal her in size and weight. — M. P. E. G. 



112 THE EXCEPTIONAL CHILD 

as she is in mental performances. But her physical 
growth, otherwise, is most pronouncedly in excess of 
girls of her age, so that her nervous system is supported 
by bodily resources. It is further important to note 
that Mrs. Stoner recognizes the period in her child's life 
completed so far as the "memory period," the "reason- 
ing period" just having begun. As a matter of fact, 
what I have seen of the child's literary productions is 
characterized by a good use of memory, with strong 
power of imitation and imagination, rather than mature 
and independent reasoning. How she can, under the 
circumstances, compete with a really mature college 
graduate would not seem quite clear. She is certainly 
"book-minded" to a degree, with some disregard for 
manual and practical training. Maybe she is predis- 
posed for this literary quality by hereditary and environ- 
mental influences no more than by the gift of an excep- 
tionally good visual and aural memory, such as will be 
described later in the discussion of other types of excep- 
tionally bright children. 

Mrs. Stoner has rendered a distinct service to educa- 
tion by giving us an insight into the details of her meth- 
ods with her exceptionally gifted child, and the author 
of this book has no desire here to enter into any detailed 
review or criticism. She calls her procedure, which she 
does not call a distinct system (being rather the applica- 
tion of good educational principles to a special case), the 
"natural education." It is very doubtful, however, 
whether it is safe to generalize from her experience with 
the one child — an only child at that, surrounded by cer- 
tainly unusual life conditions. Winifred's life is by no 
means as "simple" as Mrs. Stoner thinks, if we compare 
the girl's opportunities with those of other girls. One 



EXCEPTIONALLY BRIGHT CHILDREN 113 

thing ought to be mentioned: the entire omission of the 
father's influence and co-operation, so that Winifred's 
educational atmosphere appears as most definitely fem- 
inine. 1 The author fears that Winifred's education has 
not been "natural" in the sense of opportunities and 
conditions which are "natural" with all children, even 
all gifted children. She has enjoyed many things which 
were exceptional, and missed others which are "natural" 
to most children. If, by the way, she would be "most 
unhappy" if deprived of her book companions for a 
single day, she is apt to be ill-prepared for reverses which 
would change her opportunities. 

Two other cases of exceptionally bright children of 
this class which have come under the author's personal 
observation may here be cited for further illustration. 

One is that of W. S. (Case 19), a boy of 5^2 years, 
of wealthy, intelligent parents. This is the statement 
recorded after a brief test at the Educational Clinic of 
the National Association for the Study and Education 
of Exceptional Children in Plainfield: 

Parents' Report 

The boy is reported by the parents as being generally preco- 
cious, with a good command of language, reading almost any 
kind of book, and having a fair skill in writing. At one time he 
committed to memory forty-two consecutive pages of Kipling's 
"Jungle Book," remembering the place of each sentence on the 
page it was printed. It is also stated that he has an excellent 
number concept, having worked out the multiplication tables 
up to twelve by himself. He is reported to be less apt in manual 

1 Mrs. Stoner, to whom these statements were shown, protests that 
" Daddy Stoner has taught Winifred many things. Through him she 
gained her knowledge of physiology, swimming, horseback -riding, and 
many other important matters. She is not a distinctly female-educated 
child." 



114 THE EXCEPTIONAL CHILD 

work. He has had little contact with other children and finds 
adjustment with them difficult, although he is always willing and 
pleasant. 

Physical Observation. — W. is generally healthy, although he 
is somewhat nervous and has a slight difficulty in the control of 
larger limb movements, as well as of minute muscular co-ordina- 
tions. Sense-perceptions are found to be normal. 

Clinical Tests. — The Binet Tests which were applied for the 
sake of comparison would place him at a "mental age" of about 
twice his chronological age. This result, however, does not 
correctly state his case. Other tests showed that he possesses 
a most remarkable visual memory, which will in part explain his 
splendid success in reading and number. He visualizes readily 
and remembers every detail. He performed the series of five 
Knox Cube Tests correctly and immediately; completed 24 of the 
56 Completion Test sentences, and would have completed more 
had he not become tired and restless. He solved the geometrical 
Anchor Puzzle in a rational manner, after having been shown 
the initial steps. In contrast to this, he was disappointing in 
handling the Healy Form Boards Nos. 3 and 5. He completed 
No. 3, but in doing so disregarded the picture element entirely, 
mechanically fitting the insets into the grooves, making a num- 
ber of irrational mistakes before succeeding. This showed that 
he was working exclusively from the form concept. In No. 5 
(Picture Completion Test), which requires a judgment of situa- 
tions, he failed. 

His response was prompt and eager; his attention and endur- 
ance, however, were variable. 

Conclusions. — Scholastically, he may be placed in the Elemen- 
tary Period, and would possibly be able to do ordinary work in 
lower grammar-classes. He lacks, however, the maturity of 
mind which would enable him to do such work rationally and 
profitably. His precocity is marked (non-pathological); it is 
apparently of a linguistic and formal type, characterized by 
powerful visualization and extraordinary memory. 

It will be well for him to go slowly in school work, as this 
would hardly help him in mental development. He should have 
mainly an outdoor life with practical experiences of all kinds, 
and contact with other children. His motor side needs stimu- 
lation to offset his linguistic and sensory tendencies. He should 



EXCEPTIONALLY BRIGHT CHILDREN 115 

have a chance of "roughing it," running up against obstacles, 
and discovering his limitations. He should have a minimum of 
protection and a maximum of personal experience. 

It is quite possible that he will develop into a man of power 
and leadership. 

The second case is that of P. E. G. (Case 20), a little 
boy of 2 years, 11 months, the child of intelligent and 
slightly neurotic parents, whose history the author has 
quite complete. His development is generally acceler- 
ated, bodily and mentally, without one-sidedness or path- 
ologic precocity as far as present observations go. His 
first and second year's development is given more in 
detail in the appendix (p. 707). 

At 26 months he was very fond of playing in the gymnasium, 
rolling dumb-bells, playing football, climbing vertical ladder, etc. 
He put his playthings in order, picking up cards, blocks, etc. 
Liked to arrange things in rows. Half a month later he sang, 
repeating notes and combinations so as to produce a simple 
melodious rhythm, making up his own text about Jack Frost 
coming, biting baby, etc. He now spoke in sentences, making 
sequences of sentences, combining them in compound, and at 
times even in complex, structures. 

At 28 months he operated shutting off buzzer at telephone 
switchboard. Very fond of any kind of machinery, which he 
likes to investigate. Added to his gymnastic performances: 
swinging on rings (with hands supported by father); balancing 
himself with hands on table and feet propped up on back of 
chair, several feet away; jumping with both feet on and off his 
small overturned rocking-chair, etc. Said: "Baby go with papa 
down-town; both go down-town." 

At 2 years and 7 months he talked and reasoned amazingly, 
even in repartee. 

At 2 years and 9 months he attended a big three-ring circus. 
Deeply interested in performances and in the animals of the 
menagerie, particularly the elephants. Since then played circus 
and menagerie, feeding elephants, etc., in many ways, like a 
much older child. 



116 THE EXCEPTIONAL CHILD 

Half a month later these are some of the expressions recorded: 
"Oh, thank lou, dear God, for the sunshine!" "Doctor thinks 
William is feeding my chickens. But he does not. I want the 
food for my chickens. I will feed them myself." "I am taking 
water to my chickens." To the cook: "See, God listened to me 
and sent the sunshine." 

With 2 years and 10 months he began to build structures with 
wood and odd material in the garden; played with his many 
engines, cars, autos (toys), pieces of board — arranging them in 
lines, squares, and open spaces, as barns and houses, with doors, 
etc.; sometimes laying pieces across on top, for roofs. Out of 
window-sash, old uprights, broken windows, branches of trees, 
etc., he built a "stable" outdoors, near a tumbled-down barn, 
directing his nurse to do the things which he was not big enough 
to do. 

At the time of this writing, when he is 2 years and 11 months 
old, he knows his full name, has a very full vocabulary, to which 
he adds daily, uses the comparative frequently, understands 
weather conditions, is full of poetic imaginations and make- 
believe play, always constructively active. His height is 39^4 
inches, his weight 37^ pounds. Physically he resembles a 
5-year-old boy, wearing even 6-year size of clothes. He is gen- 
erally robust and healthy, and when troubled with indigestion 
or otherwise, shows a wonderful recuperative quality. The 
Binet Tests would place him at a "mental age" of about 5^. 
But he is really much further advanced in general intelligence 
(excluding school branches, like reading and writing) and in 
constructive judgment and reasoning power. He has a quick 
grasp of situations and always finds his place. He remembers 
everything, and is a constant amazement to his parents and 
friends through his ability to reason out things of which he 
cannot have a direct experience. He has absolute balance. Ac- 
complishes the first and second move of the Knox Cube Test; 
uses the peg-board for construction of "houses"; follows more 
than three simultaneous directions; can tell little stories from 
pictures; understands categories; arranges eight tubes according 
to length; matches his playthings and other things perfectly, 
noticing the slightest difference; does the Seguin Form Board 
Test rationally, and in a short time; imitates building a bridge, 
etc. 




6 3.- 
■ g a 

I > o 



^--7- 



— C3 



EXCEPTIONALLY BRIGHT CHILDREN 117 

In no one thing can this little boy be said to be specially gifted, 
at present, unless it were in the matter of construction and dis- 
tinct leadership and organizing qualities. But he is generally 
advanced, far beyond his actual age, and promises to become a 
man of power at an early period of his life. Both his mother 
and his father were precocious in youth. 

As long as the physical health and strength of children 
of this type keep pace with their mental advancement, 
there is nothing to fear. But they certainly need to be 
given the opportunity to live and learn according to 
their quickened rate. They must not be held back to 
chafe under the restraint of their vitality and initiative, 
and must be given tasks commensurate to their strength 
and ability to cover ground. They need, however, care- 
ful observation and skilful handling. The brilliancy of 
not a few of them will "peter out" unexpectedly at a 
later age unless there is a foundation of strong mental 
and physical vitality and resource. 

The warning must be given that at the first sign of 
tension between bodily and mental development, or in 
the emotional sphere, such as is likely to appear at the 
adolescent stage, a new adjustment becomes imperative. 

For even these non-pathological children may at times, 
especially at certain growth periods, e. g., during the 
fatigue period around the eighth year, or at the time of 
puberty, develop a degree of disparity between bone, 
nerve, and muscle growth, between stages of central and 
peripheral changes, between the size and function of 
certain organs, that danger of derailment is imminent. 
It is therefore commendable to watch the physical health 
of these children at all stages with particular care, and 
to make promotion, even continuance in school, depen- 
dent upon a clean health record. 



118 THE EXCEPTIONAL CHILD 

Much depends upon the kind of stock from which 
such a child has sprung; a virile heredity is a good prom- 
ise of wholesome advance. Environmental conditions 
play their part, favorably or the reverse. 

The last two groups of exceptionally bright children 
are those who suffer the most from lack of adjustment 
in the ordinary educational system, in home, and in 
school. 

Third Group: Children of One-Sided Development 

This is the type of child in whom one faculty, or group 
of related faculties, is developing at the cost of all or 
most of the other faculties, or related groups of faculties. 
These children will be bright and progressive in certain 
directions, and dull and ineffective in others. Distinct 
types can be differentiated: the motor type, which is 
largely constructive along motor lines; the sensory type, 
in which sense-perceptions are particularly keen, and 
impressions dominate over expression; the artistic type 
(musical, poetic, graphic, creative); the mathematical 
type, which is distinctly abstract; the scientific type, in 
which abstract and constructively practical elements 
blend; the linguistic type, which is either scientific, i. e., 
philological, or practical, i. e., characterized by facility in 
acquiring language and languages. Naturally, there are 
combinations. The sculptor and the architect are art- 
ists, but they belong to the motoric type of artists. The 
architect depends upon good mathematical endowments 
and must possess sufficient scientific instincts to battle 
with the properties of the material he uses and the prob- 
lems of structural security. It is interesting to note 
that individuals of so-called "universal" genius, like 



EXCEPTIONALLY BRIGHT CHILDREN 119 

Michael Angelo (Case 21), have combined just such ele- 
ments, being especially proficient in each and all of 
them. Then we may have an individual of linguistic 
type endowed with poetic genius, so that he becomes a 
master of words, and capable of rendering masterpieces 
of foreign origin in his own language, re-creating them, 
as it were, instead of merely translating. Among the 
Germans Riickert (Case 22) was one of these; among 
Americans Longfellow (Case 23) ; among the Irish Man- 
gan (Case 24), etc. 

Some of the apparently unusual special equipment is 
deceptive and transitory. We have frequent examples 
of seemingly well-gifted high school and college students 
who excel in one or another thing, becoming class lead- 
ers, editors of fraternity papers, etc., and who fail dis- 
mally in after-life to make good in the very things they 
seemed to excel in during their college days. Such 
things are often a matter of temporary opportunity and 
ephemeral fitness. 

Also children of ordinary endowments differ in type, 
as has been shown in previous chapters, without exhib- 
iting unusual gifts in any particular direction. Even 
these are in danger of becoming mentally and morally 
warped if forced to conform to "general" treatment and 
"average" school aims. This danger is incomparably 
greater in the case of unusually gifted children of the 
class we are discussing now. If they lose their balance 
and get out of touch with normal life conditions, their 
special talents may be the instruments with which they 
commit antisocial acts. Here we approach the problem 
of juvenile delinquency, which will be treated in another 
chapter more fully. 

The children of this group need a training which takes 



120 THE EXCEPTIONAL CHILD 

the lead from their specialty and makes all other mental 
activities focus in it, giving them motive power along 
socially constructive courses. Under the guidance of 
wise parents and teachers such children will become 
splendid social assets, their specialized efficiency giving 
to the world helpful culture increments of unusual 
amount and concentrated potency. Their special gift 
furnishes the point of vantage from which they will enter 
the entire field of learning, thus counterbalancing an un- 
healthy one-sided development as far as possible. But 
unless the child's main interest is taken as the starting- 
point, he may become hopelessly averse to study and all- 
around culture, degenerating into a drifter or a narrow- 
minded egotist, devoid of socially constructive energy. 
Here is the case of W. B. (Case 25), a boy of 16: 

A mechanical genius; has constructed several workable motor- 
boats; erected a telegraph-line between his playhouse and his 
home. Also erected a wireless station on his home grounds. 
He has recently raised his wireless antennae 75 feet above the 
ground. Goes about with his pockets full of tools. Interested 
in machines of all kinds, not to use them, however, but to study 
their mechanism; it is not the moving pictures but the picture- 
machine which interests him. He received a typewriter to learn 
on, but broke it up to study the machinery. Takes bicycles, 
watches, etc., apart continually. Not much interested in the 
usual boys' games; never very enthusiastic over anything; calm 
and self-possessed; physically normal and healthy, but a sexual 
pervert. Has been a failure all along in grammar-school. No 
tutoring at home could get him into high school. As parents 
refused to try special training away from home, his case could 
only be studied, not relieved. 

Very differently did another case develop: 

H. H. (Case 26), a boy of 13. A decidedly inquisitive and ex- 
perimental type. Built fires in the cellar of his home, not from 



EXCEPTIONALLY BRIGHT CHILDREN 121 

viciousness but because he wanted to see what would happen. 
Played innumerable pranks on his schoolmates and teachers, who 
did not understand him, so that he was constantly in mischief 
and upset all discipline. After he had entered Herbart Hall 1 his 
inquisitive tendency was made use of through experimental stud- 
ies of all kinds, in the science laboratory, in the workshop, in 
road and building construction, and in many other ways. He 
was given opportunity to apply his great energy in numerous 
outdoor games and sports, playing Indian, building wigwams, 
camp-fires, etc. His book-studies were carefully co-ordinated 
with this life activity. He stayed only a few months, and left 
altogether rearticulated, mentally and emotionally. Since then 
he has been standing at the head of his classes in select private 
schools. 

The case of the little 5>£-year-old boy, W. S. (Case 
19), mentioned in the previous group, may be referred 
to here, if we should be inclined to consider his lin- 
guistic and mathematical tendencies sufficiently pro- 
nounced to outweigh his other possibilities; this, however, 
would perhaps be a premature conclusion. Reference 
may be made to the historical personality of Ulysses S. 
Grant (Case 27). When he retired from the army after 
the Mexican War he failed in every business pursuit in 
which he engaged. He was distinctly of a non-practical 
type from the point of view of commercial efficiency. 
But he found his place again as a leader of men when his 
time came. 

1 At that time used as a laboratory school of the " National Associa- 
tion for the Study and Education of Exceptional Children," at " Watch- 
ung Crest," Plainfield, N. J. 



122 THE EXCEPTIONAL CHILD 

Fourth Group: Children of Neuropathic and Psycho- 
pathic Tension. 1 

Here we have the genius and the crank; the great 
leader of men, the prince of commerce, the poet, and 
the philosopher; the musical prodigy and the artist of 
high degree, with his Bohemian contempt for conven- 
tionalities. The distinction between representatives of 
this group and the previous group is not always easy 
to make, and depends largely upon the psychic aspect 
of the case — upon the equipoise of the nervous system 
and the stability of the mental stamina. Sometimes it is 
merely a matter of degree, or grade. An individual of 
one-sided development may easily slip into the truly 
pathological class at any given moment of tension. 

In some individuals of this fourth group sentiment is 
apt to overpower the reasoning faculties, and hysterical 

1 It may be well to insert here the definitions of various terms as used 
by the medical profession: 

Neurasthenia: exhaustion of nerve force. Neuropathic: pertaining to 
nervous diseases. Neurosis: a nervous affection without lesion. Neu- 
rotic: nervous; pertaining to neuroses; pertaining to the nerves or the 
nervous system. Neurology: science of nervous structure and function. 
Neuropsychosis: a combined nervous and mental disease. Psychiatry: 
the treatment of mind diseases. Psychosis: any disease of the mind. 
Psychotherapy : treatment of disease by mental influence. Psycfto pathol- 
ogy: the pathology of mental diseases. Psychoneurosis: a functional 
mental disease. Psychopathy: any disease of the mind (cf. psychosis). 
Psychasthenia: mental fatigue (sometimes used in the sense of mental 
weakness = feeble-mindedness). 

It will be seen that the terms are not very clearly differentiated in 
every way; later writers employ them in individual ways. Some insist 
that every psychopathic condition is a neuropathic condition, and vice 
versa. But neurologic terms are mostly used to denote physiologic 
function; psychologic terms, to denote mental function. .These two 
functions are, however, so minutely interrelated that substitution of 
terms cannot always be avoided. 



EXCEPTIONALLY BRIGHT CHILDREN 123 

conditions are frequent. Or there is cleverness of ex- 
treme acumen untempered by qualities of the heart. 
There is always some psychic defect present which en- 
dangers the mental equilibrium. In this sense genius is 
akin to insanity. The greatest criminals of history belong 
to this class, whether they were international crooks, or 
sitting on thrones, or in the counting-houses. In them 
the moral tone is unhealthy, self-control is weakened, 
the ego is exaggerated and morbidly sensitive. In cer- 
tain individuals of this class overefficiency in one direc- 
tion is offset by complete underdevelopment in all oth- 
ers; here we have the idiots-savants. 

Individuals of the idiot-savant type exhibit the most 
prodigious ability in a certain well-circumscribed field 
while all others He fallow. Musical prodigies, lightning 
calculators, and memory prodigies of this type may be 
clearly idiotic and feeble-minded, and their special gift 
appears as the result of a mechanical process in the 
brain which has no significance for the intellectual value 
of the individual. The very facility of a man like Inaudi 
(Case 28) to give immediate answers to extremely com- 
plex mathematical problems with large rows of figures 
eliminates conscious thought and judgment entirely, and 
places him in the class of freaks of nature. In a large 
institution for the feeble-minded the author saw a young 
man, distinctly idiotic, who was able to tell you in- 
stantly, when told the date of your birthday, on what 
day of the week it would fall that year, or on what week- 
day you were born (Case 29). Such persons are mere liv- 
ing calculating-machines. The study of their cases has 
this significance that it will throw light upon certain me- 
chanical and subconscious processes in the central ner- 
vous system which are involved in mental operations. 



124 THE EXCEPTIONAL CHILD 

According to Tredgold, there is a man in the Earls- 
wood Asylum, England, who entered at the age of 15 
and is now over 70. He did not walk until 7 years 
old, was never tolerated in school and learned to write 
and spell only a few simple words. His memory was 
good and he showed an early aptitude for drawing. He 
was very deaf. After sixty years' work, this man has 
over fifty excellent crayons to his credit, wonderful carv- 
ings in wood and ivory, and a 10-foot model of a full- 
rigged man-of-war of the old wooden type, built to the 
minutest detail. He has also constructed a huge and 
awe-inspiring mechanical doll, 13 feet high. By a won- 
derful internal machinery this figure will turn its head, 
raise its arms, open and shut its eyes and mouth, pro- 
trude the tongue, etc. Yet this man is feeble-minded, 
superlatively egotistic, glories in self-praise, and is stub- 
born and emotionally unstable. He is a genius, yet 
cannot take care of himself in the outside world except 
under supervision. He is considered an idiot-savant. 
But what might have been his possibilities if properly 
diagnosed in childhood? (Case 30.) 

Wunderkinder. Another class in this group, the one 
to which the German term "Wunderkinder" has been 
applied, develops marvellous excellency without com- 
pletely destroying the balance of the mind. Genius rep- 
resents the most brilliant type of this order, and is a 
" Wunderkind " grown up. 

Doctor Paul Carus says this about the genius: l 

The soul of a genius consists of motor ideas which are correct 
representations of things in the objective world and of the work 
to be performed. They interact without the laborious effort of 
conscious concentration. They act with machine-like accuracy, 

'"Our Children," p. 154. 



EXCEPTIONALLY BRIGHT CHILDREN 125 

so as to allow attention to be concentrated upon the main pur- 
pose of the work and not upon its details. A genius originates 
partly by inheriting a disposition for easily acquiring certain 
functions, or generally by possessing the knack of viewing the 
world correctly. Whatever may be the cause of genius, it cer- 
tainly shows itself in the playful ease with which work of great 
importance is performed. . . . Genius is instinct on a higher 
plane. 

This would show a relationship between the genius 
and the idiot-savant, inasmuch as there is the mechanical 
element in the make-up of both. There is more of in- 
stinctive impulse than of conscious application. But the 
difference consists in the use for higher purposes of ac- 
tivity which the genius consciously makes of his instinc- 
tive endowments. It should be noted that Carus recog- 
nizes the part which motor ideas play in the constitution 
of the genius, a fact to which reference will be made 
later. 

An Early Reader. — What this mechanical element is 
may become clearer from a report published in the 
Zeitschrift fiir Kinder f or schung (Langensalza, March, 
1 910), on one Otto Pohler (Case 31), the early reader of 
Braunschweig. 

He began to read letters, words, and figures at the tender age 
of x% years. 1 The case of this boy, who was at the time of the 
writing of the article nearly 17, has been carefully studied, and 
cranial measurements have been taken. It appeared that when 
he was a child his occipital bone was unusually prominent, and 
the axes of the eyes were farther apart than in average children. 
Doctor Oswald Berkhan comments as follows: "Professor Her- 
mann Munk has shown that the convolutions of the hindbrain 
have a close connection with the visual function, and that in 
this region (he calls it the visual spheres = ' Sehspharen ') those 

1 Cf. the accomplishments in this field of Winifred Sackville Stoner, Jr., 
p. 108. 



126 THE EXCEPTIONAL CHILD 

perceptions which were obtained from the optic nerves are stored 
up as memory images. It is therefore not improbable that the 
prominent occipital bone corresponds with a stronger and more 
deeply convoluted hindbrain, the centre of the optic images of 
written and printed symbols, i. e., of the memory images of the 
words read. And the relatively greater distance of the eye-axes 
permits of the assumption that there is an extraordinary arrange- 
ment of the convolutions of the forebrain." 

This indicates that the source of the boy's exceptional ability 
to read, and later on to acquire foreign languages, history, etc., 
was an exceptional visual perception and memory, based upon a 
special anatomical endowment. 

It is well to bear this observation in mind in judging 
of those children who may be more directly contrasted 
with these facile readers, namely those who have par- 
ticular difficulty in reading, writing, etc., without suffer- 
ing outspokenly from alexia and agraphia, and without 
showing other mental defects. They will be referred to 
in later chapters. It is quite possible that in them the 
opposite anatomical and physiological arrangement ex- 
ists. In the author's clinical observations he has invari- 
ably found that children whose progress in these school 
studies was slow and unsatisfactory, had poor powers of 
visualization, and impaired visual and aural memory, even 
when their power of judgment and rational thought appeared 
unaffected. 

An exceptional and quickly acting memory power will 
explain many otherwise strange phenomena in the mani- 
festations of these "Wunderkinder," and this memory 
is intimately related with corresponding motor impulses. 
It is essentially a matter of motor ideas, as Carus puts it. 

The facts here stated may also throw light upon the 
conditions of the non-pathological classes of exception- 
ally bright children, and explain their special gifts. 

The early faculty of Otto Pohler to read figures was 



EXCEPTIONALLY BRIGHT CHILDREN 127 

not accompanied by a corresponding ability to compute, 
showing it to be in the nature of a visual mechanism. 
The boy was at the time of the writing of the article an 
intelligent young man, endowed with an admirable mem- 
ory, well educated, pleasant of manner, who is always 
ready to find his proper place. Otherwise there is noth- 
ing remarkable about him, although he promised to be 
a very successful student of history. The anatomical 
peculiarities spoken of before are less marked in the youth 
than they were in the child. 

The interesting pathological symptoms reported in this 
case at the time his precocious reading faculty was most 
marked, in his childhood years, were a tendency to stut- 
ter and to have spastic movements of the muscles of the 
mouth. A good constitution and careful observation 
saved the boy apparently from nervous dangers. 

The Artistic Type. — Very different is the character- 
picture of another type of "Wunderkinder," the artistic 
type. Take the musical genius, Wolfgang Amadaeus 
Mozart (Case 32) for an example. Mozart showed re- 
markable musical ability at 3 years of age. But he was 
never a well-balanced personality. He was impulsive, 
careless, erratic, a very poor manager. His irresponsi- 
bility in money matters, his happy-go-lucky way, caused 
him always to be in want. Toward the time of his early 
decline, when he had exhausted his opportunities and 
nerve-force in a spendthrift sort of way, he became mor- 
bid, and died at the early age of 35. 

His was clearly a pathological case. Not all excep- 
tional minds end so ingloriously and early. Professor 
Francis Galton says: "Early manifestations of genius are 
not incompatible with prolonged and even late develop- 
ment. Haydn (Case 33), Beethoven (Case 34), Michael 
Angelo (Case 21), Milton (Case 35), Goethe (Case 36), 



128 THE EXCEPTIONAL CHILD 

Voltaire (Case 37), Newton (Case 38), and others are 
examples of lengthy process of development. Men of 
great original power may be expected to illustrate the 
most prolonged movement of mental growth." Never- 
theless the danger of pathological tension is ever present, 
and too much care cannot be exercised in watching over 
these developments. When there is a virile physical 
basis for exceptional excellence, we may count such ge- 
niuses among the non-pathological classes. But it may be 
found on closer analysis that all of the men mentioned 
by Galton had their weak spot, their danger zone. 

The Mathematical Prodigy. — The mathematical prod- 
igy is another type. Gauss (Case 39) and Newton (Case 
38) belonged to this type. With the mathematical abil- 
ity is often coupled a high degree of effectiveness in the 
exact sciences, as astronomy, logics, etc. 

The modern "Wunderkind" of this class is William 
James Sidis (Case 40), who as an 11 -year-old boy ad- 
dressed Harvard professors on the problem of the fourth 
dimension. In some respects he reminds one of Otto 
Pohler. He, too, was an early reader, had a great inter- 
est in words and figures, and had mastered five foreign 
languages at the age of 8. He had studied anatomy 
and astronomy. But his main capacity seemed to be 
mathematical. 

In a public discussion of the Sidis case 1 Doctor Philip 
S. Goodhart, of New York, a friend of the Sidis family, 
who had assisted at the boy's birth, said : 

There seems to be a general misunderstanding, both in the 
lay mind and in the scientific world, of the conditions of life, the 
manner of education, and the general make-up of this remark- 

1 Cf. " Proceedings, National Association for the Study and Education 
of Exceptional Children," 1910, p. 112. 



EXCEPTIONALLY BRIGHT CHILDREN 129 

able boy. His father, Doctor Boris Sidis, is a personal friend 
of mine, and I brought the son into the world. Doctor Sidis 
and myself have been closely associated and have done literary 
work conjointly. The elder Sidis is a highly intelligent man of 
rare intellectual acumen, and is highly cultured. He has always 
been a close .student of normal and abnormal psychology, and 
much of his work has shown profoundness, and has always been 
stamped by originality. 

The mother of young Sidis is a graduate physician and also 
a talented woman. Both parents are of Russian- Jewish ex- 
traction. 

The Sidis boy was, both mentally and physically, normal 
and in every sense an average child during his infancy and very 
early child life. Doctor Sidis began with his son in early child- 
hood a system of instruction along original lines which, while 
not destroying the childlike tendencies, awakened and developed 
in the child powers of observation, analysis, discernment, and 
general intellectual activity, which he applied in the diversions 
and ordinary pastimes of the child's life. The child was thus, 
without an effort, utilizing receptive and perceptive, as well as 
conceptive mental processes which were along lines tending to 
develop a potent brain force. In the results achieved by the 
Sidis boy, doubtless both the elements of heredity and those of 
environment played an active role, and these forces were most 
happily combined to bring about excellent results. The boy is 
not physically a weakling, and while it is true he may be at 
times nervous and perhaps moody, up to within a few years 
past, when the boy ceased to be under my observation, he was 
enjoying the best of health. It must be admitted, however, 
that the child has been characterized by a certain awkwardness 
in manual activity and motor expression. In his childhood he 
passed through several severe attacks of illness, but showed 
excellent recuperative power. 

In the same discussion the author commented on 
Doctor Goodhart's remarks in the following manner: 

I was much interested in what Doctor Goodhart said in re- 
gard to the Sidis boy. While, of course, a more detailed study 



130 THE EXCEPTIONAL CHILD 

of the child's physiological and psychological characteristics 
would make matters clearer, the statements of a man like Doc- 
tor Goodhart, who has known the boy and his family intimately, 
are significant. He states that there is a certain lack of nervous 
balance and control in the boy, and that he is awkward in man- 
ual activity and motor expression. This means that the areas 
in his brain which control motor activity are underdeveloped, 
and that his nervous system has not its normal strength. These 
very conditions establish danger-signals, and give the basis for 
an undue strain which may come sooner or later. 

It has been impossible for the author to confirm or 
dispel his apprehensions, as all attempts to secure from 
the boy's father a statement of facts of his further de- 
velopment have resulted in failure. At the present 
writing the boy must be about 19 or 20 years old, and 
it is to be regretted that his development is not open 
for scientific discussion, after his case had formerly been 
given such wide publication. 

It may be emphasized right here that all the excel- 
lencies of intellectual work done by William James Sidis 
have been in the sphere of abstract thought. 

Other Cases. — Here are a few interesting cases from 
the author's own practice: 

W. B., a boy of 0, highly nervous and with a system full of 
malaria. His principal asset and excellency was a most marvel- 
lous imagination. He was very mischievous and irresponsible. 
Once, playing Wild West, he became so realistic that one of his 
comrades escaped an actual hanging only by the interference 
of a passer-by. Most erratic in school and home, he, who had 
been almost given up in despair by his parents and his physician 
(by the way, one of the foremost specialists, who had recom- 
mended a trial at Herbart Hall), had a year's training at our 
laboratory school, where his diet, regimen, schooling, occupa- 
tion, play, etc., were carefully arranged. He blossomed out 
into an amazing case of progress, constructive imagination, and 



EXCEPTIONALLY BRIGHT CHILDREN 131 

self-direction. He went back to his home and to ordinary- 
schools, saved from physical and mental disintegration, making 
good in every way, as one of the brightest boys among his fellows. 
(Case 41.) 

Two other cases did not develop so favorably, largely 
owing to the fact that they were not given sufficient 
time for re-education and balancing. Both children had 
most remarkable artistic ability and might have devel- 
oped into painters of exceptional talent if the parents 
had consented to giving them the opportunity of efficient 
teaching. One of the two, a boy (A. S., Case 42), is 
now, n years after his removal from Herbart Hall, at 
the age of about 27, a shiftless vagrant, without intelli- 
gent self-direction or stability of occupation, a burden 
to his parents and to the community. Two of his origi- 
nal art productions (both done at the age of 14) are here 
shown. One is a free-hand drawing of one of his teach- 
ers, quite realistic and full of characteristic pose; the 
other a water-color sketch of remarkable composition 
and atmosphere. He had made rapid strides forward 
when his re-education was interrupted. 

The other child was a girl (H. H., Case 43) whose 
talent for the graphic arts was equalled by one for music 
and dancing, as well as appreciation of poetic beauty. 
She came to Herbart Hall, an adolescent girl with a 
number of psychopathic tendencies, among them a sui- 
cidal mania. Two of her art pieces are here reproduced. 
She would have needed years of re-educational effort, 
but was not given an opportunity. Now she is an in- 
mate of a hospital for the insane. Yet she had been 
responsive to the mental hygiene at Herbart Hall, and 
would have had a good chance of recovery. Her case, 
as well as that of the boy, A. S., showed symptoms of 



132 THE EXCEPTIONAL CHILD 

predementia precox. The girl's case was aggravated by- 
sexual morbidity (eroticism). 

General Discussion. — Considering the general prob- 
lem of the exceptionally bright child, we may again first 
consider normal possibilities. The case of the Sidis boy 
which helped to illustrate the fourth group of exception- 
ally bright children, may serve as a starting-point. 

Doctor Sidis claims that his boy's remarkable mani- 
festations are the result of an educational system of his 
own. He availed himself of the opportunity of every 
newly awakened interest, and states that much more 
intense work could be done by every child if a more 
rational use were made of what has been called " second 
breath," or "second wind," and by Professor William 
James, "reserve mental energy." 

The Proper Method at the Right Time. — The conten- 
tion is justifiable in a measure. Each child has budding 
or "nascent" periods for the different forms of mental 
work. The early years are the ones in which the nam- 
ing, the language-making, the counting, the computing 
instincts arise, and in which a wealth of more or less 
conscious observations and experiments are made and 
stored up in the form of mental images and dormant im- 
pulses. These facts, however well known to some, are 
yet too little understood and hardly recognized in prac- 
tice. It is perfectly possible to assume that we might 
succeed in developing a very large number of our chil- 
dren to undreamed-of mental alertness and efficiency, if 
proper use were made of these budding interests before 
they evaporate; and if a careful training of the attention 
were attempted alongside of proper methods of teach- 
ing the child individually at the right time. It is really 
in many ways a matter of the proper method at the 




Fig. S. — Water-color sketch (illustrating story) by A. S. The 
duction does not do justice to the fine color effects. 



repro- 




Fig. q. — Outdoor sketch by IT. TT. 



EXCEPTIONALLY BRIGHT CHILDREN 133 

right time. Cams is right in saying {loco cit.): "The 
impressions of children who, in a certain line of activity, 
see nothing but the right methods from their very baby- 
hood, will be so organized that from their unconscious 
depths up to the conscious surface of their soul, they 
will be predetermined to hit naturally the right mode 
of action. . . . The condition of genius is a ready and 
automatic interaction of a sufficient number of clear and 
correct thought images, or representative pictures, which 
must be brought under the control of a guiding purpose." 

Suggestion. — Professor David Edgar Rice, of Colum- 
bia University, thinks that the achievements of the Sidis 
child are due to suggestion. "There seems to be scarcely 
any limit to the power of suggestion, and it is conceiv- 
able that by some process the father has been able to 
stimulate the natural powers of the child's mind to an 
extraordinary degree." This is very possible, indeed, 
and it may be urged that a well-balanced suggestive 
method has a place in education in all cases, not only 
when there is need of checking perverse or morbid dis- 
positions. Suggestion has a very positive value. 

Second Breath. — Further, the theory that we can do 
much more intense and sustained work by calling upon 
our physical as well as mental "second breath" is thor- 
oughly tenable. As a rule we allow premature fatigue 
to interfere with the activity of our children, a fatigue 
which is not seldom the direct result of tedious and 
unscientific methods of teaching and of unhygienic con- 
ditions. We do not work the children intensely enough. 
The most efficient man in the world is he who overcomes 
the torpidity and sluggishness of ready fatigue. Draw- 
ing upon our hidden strength, we develop latent possi- 
bilities and bring into activity those brain cells and 



134 THE EXCEPTIONAL CHILD 

thought and motor centres which lie dormant and are 
in danger of remaining undeveloped, even of atrophy. 
The number of brain cells functionally active is difficult 
to determine; but we have seen before (p. 20) that it 
comprises only a fraction of the entire number of cells, 
many of which remain forever immature. 

Who will venture to deny the possibility that by 
proper stimulation we may vastly increase the number 
of functioning cells, and thus of the potentialities of 
thought and of motor activity? 

By proper methods of stimulation the association 
paths from cell to cell will be multiplied, organized, and 
worked smooth, so that there will be a corresponding 
increment of mental power and of rational judgment. 

Subconscious Self. — To what extent our subconscious 
self may become correlated with our conscious life, so 
that a vast area of occult organized mentality may be 
brought into rational co-ordination, is a matter of specu- 
lation at this time. The problem, tremendous in its 
possibilities, may here be merely broached. 

Space and Time Concepts. — Let us also be reminded, 
in discussing the conditions of rapid growth, that space 
and time are mere abstractions, or methods of conception. 
Both are motor concepts, and depend upon rhythmical 
elements of variable rate. Our mind, under certain 
stimuli, defies "time." Many are the experiences in 
our dream life, or under stress of great excitement, when 
we live through apparently long periods of time in the 
space of a single moment. Time as well as space is a 
relative standard. Thus, mind development may "defy 
time." 

Anatomical Structure. — We may look further for an 
anatomical explanation of special gifts. A very sugges- 



EXCEPTIONALLY BRIGHT CHILDREN 135 

tive statement is found in Church and Peterson's work 
on "Nervous and Mental Diseases" (pp. 159 Jf.) : 

As a working scheme we may consider that motion is repre- 
sented in three levels: First, in the gray matter of the spinal 
cord; second, in the Rolandic area of the cortex; third, in the 
highest levels of conscious thought, probably in the frontal 
region of the brain. The spinal level may be considered that 
of reflex, vegetative automatism; the Rolandic level that of 
motor memories; and the frontal area that of conscious, selective, 
and intelligent action. Thus, destruction of the highest level 
leaves automatic and memory action practically unimpaired. 
... In the automatism of dementia the motor memories are 
likewise preserved. The mid-level, the Rolandic region, may 
be destroyed, leaving consciousness of volitional motions and the 
will to execute them, but the memory of their muscular produc- 
tion is gone, and they default as, for instance, in motor aphasia. 
If the lowest or spinal level be destroyed, the mind and the 
memory organ have lost their tool, and peripheral paralysis ob- 
tains. There is no difficulty in conceiving certain cortical areas 
to be memory organs, as in the case of the higher visual centres 
in the parietal lobe. We may, however, go further. All thought 
contains the two ideas of motion and sensation. They cannot 
be separated, and without them consciousness is impossible. 
Indeed, they are in a certain sense identical. Motion is to the 
mind but the sensation of a change of position, and sensation 
is only the recognition of arrested motion. If, then, we con- 
sider the parietal convolutions as visual-memory depots, we are 
equally at liberty to consider the Rolandic areas as motor-mem- 
ory depots. ... In the spinal levels single muscles or groups 
of muscles are represented. In the motor cortex co-ordinate 
and functionally associated movement memories are located, and 
in the highest level resides their volitional control and the power 
to recall and select them. 

The authors here consider pathological effects from 
impairments of one or the other of these levels. But it 
is equally simple to conceive that one or the other be 
unusually well established and developed, well organized, 



136 THE EXCEPTIONAL CHILD 

and well trained. We may thus easily deduct conse- 
quent special gifts such as have been described in the 
foregoing. If the localization of functions as given by 
Church and Peterson differ in some details from the con- 
tentions of Professor Munk, as cited before, they agree 
in the main proposition that we are dealing with visual 
and motor memories. 

Specially favorable conditions of growth, through 
proper nutrition and other environmental causes, enter 
into the process. There are, of course, also congenital 
and hereditary causes, including race peculiarities, fa- 
vorable mixture of types in the parents, reverberations 
of ancestral excellencies, etc. 

Thus it would seem that after all we have been dis- 
cussing perfectly normal processes, and that we have 
no right to assume pathological deviations in these 
cases. It is certainly conceivable that under favorable 
circumstances exceptional excellence, genius, and even 
precocity may arise without detriment to the individual. 

Pathological Complications. — Yet many factors enter 
into these exceptional developments which are difficult 
or impossible of control. The hereditary and ethnic 
factors have already been mentioned and will be referred 
to again. If a virile stock is a favorable predisposing 
element, a weak heredity forms a hollow foundation for 
precocious development, and a "mortgaged inheritance" 
of biological elements will burden the debit side of the 
life ledger disastrously. We may readily and gladly con- 
cede that the second group of exceptionally bright children, 
the non-pathological group, as described before, will furnish 
us its complement of leaders of thought and action, of genius 
and brilliancy. But a very large number of all cases of 
genius will show neuropathic tension and danger to 



EXCEPTIONALLY BRIGHT CHILDREN 137 

health somewhere. Drawing upon the "second breath" 
too freely may become a pernicious habit, so that the 
reserve force is exhausted for cases of emergency. 1 
After all, each stage of growth has its distinct function, 
and it is well that we be sure to give each stage its ful- 
ness of opportunity, even though we may admit that 
rate and rhythm differ in individuals. Excess in any- 
thing is apt to warp development. 

Dangers of Artificial Stimulation. — Artificial stimula- 
tion and insistence upon overprecision in early child- 
hood may, as Stanley Hall shows, produce arrest of 
development. If, for instance, we expect too much of 
finer muscular adjustment in the young child (as in 
certain kindergarten and primary practices), chorea is 
often the result. The same author says: 2 

Among the chief external causes of diseases at this age (ad- 
olescent age) are all those influences which tend to precocity, 
e. g., city life with its early puberty, higher death-rate, wider 
range and greater superficiality of knowledge, observations of 
vice and enhanced temptation, lessened repose, incessant dis- 
traction, more impure air, greater liability to contagion, and 
absence of the sanifying influences and repose of nature in coun- 
try life. At its best metropolitan life is hard on childhood and 
especially so on pubescents. . . . Civilization, with all its ac- 
cumulated mass of culture and skills, its artifacts, its necessity 
of longer and severer apprenticeship and specialization, is ever 
harder on adolescents. . . . When we add to these predispos- 
ing causes the small and decreasing families, the later marriages, 
so that more and more are born of postmature parents and thus 
physiologically tend to precocity; the overnurture of only chil- 
dren, who are so prone to be spoiled and ripened still earlier by 
unwise fondness; the mixture of distant ethnic stocks that in- 

1 Barr ("Mental Defectives," p. 125) intimates that backwardness 
and precocity in early childhood are related and are equally indicative 
of an abnormal ego. 

2 "Adolescence," I, pp. 321 jf. 



138 THE EXCEPTIONAL CHILD 

crease the ferment of adolescence by multiplying the factors of 
heredity and so increasing its instability, we no longer wonder 
that many in these most vulnerable years make more or less 
complete shipwrecks at every stage of these hothouse demands 
which in the entire life of our race are so recent. Under these 
provocations, some instincts spring into activity with a sudden- 
ness that is almost explosive, and so prematurely, that as, e. g., 
with sex and drink, the strong and complex psychic mechanism 
of control has no time to develop and forbidden pleasures are 
tasted to satiety, till the soul has sometimes not only lost its 
innocence before it understood what purity and virtue really 
mean, but life is blase, a burnt-out cinder, admiration, enthu- 
siasm, and high ambitions are weakened or gone, and the soul 
is tainted with indifference or discouraged. 

Normal growth is a process of maturing. 

Any warping of this process, any excessive growth in 
some particular direction, especially in the line of spe- 
cific intellectual activity, is apt to produce an unbalanc- 
ing of the emotional equilibrium. This is the reason 
why genius is often characterized by extreme self-cen- 
tredness and selfishness, even by a tendency toward 
cruelty and sexual license. 

An International Problem. — That the problem of the 
exceptionally bright child is one which confronts other 
nations in about the same manner as it does our own, 
is evidenced, among many other facts, by an interesting 
article from the pen of a Japanese investigator, Yasusa- 
buro Sakaki, professor of psychiatry at the Imperial Uni- 
versity of Tokyo. He writes: 1 

I have endeavored to arrive at some trustworthy data as to 
the causes and varieties of abnormal intelligence in children, and 
to draw from these data some conclusions as to the treatment 

1 "Abnormally Intelligent Pupils," translated from the German in the 
Int. Archivfur Schulhygiene, by W. A. Stecher. 



i^oL tivvi^c, , £.; /$ - 2 y f 



EXCEPTIONALLY BRIGHT CHILDREN 139 

appropriate to each type. With this purpose in view I exam- 
ined all the children in the Normal School at Fukuoka in Japan, 
in which work I was assisted by Mr. Tomoziro Tomono, who is 
attached to the school in question. All the children showing an 
advanced degree of intelligence were set apart for special inves- 
tigation. We found their number to be 79 out of 332. These 
selected children were classified according to definite types into 
seven groups, and were made the subjects of a series of tests for 
mental capacity, and the results were tabulated. The normal 
children were also tested in the same manner, and the results 
compared with those derived from the abnormal children. We 
found that only one class of abnormally intelligent children was per- 
fectly free from any pathological taint, and that these were the only 
children who possessed stability of nerve-power and who exhibited 
a uniformly progressive mental and physical development. These 
we have called the true cases of abnormal intelligence, the others 
being children of the "nervous" type, precocious children, chil- 
dren mentally advanced but deficient in physique, children who 
can be spurred to mental attainments above the average through 
external stimulation, but who are not able to maintain this level 
for any length of time, and, finally, children with remarkably 
good mental capacity who are lacking in feeling and in will. 

Conclusion. — Professor Sakaki's findings tally very 
well with the views presented in this chapter. Excep- 
tionally bright children, especially those of the last 
three classes, need a very careful consideration and 
must be educated in a manner which will be fair to them 
and helpful to the race. At present they receive less 
attention than the feeble-minded and defective. Yet 
their number is at least equal to the number of abnor- 
mals at the lowest end of the scale. They are infinitely 
more worth while than those. For from them come our 
leaders and builders, our banner-bearers and thought- 
heroes, our saviors and our martyrs — as well as our de- 
stroyers, cranks, perverts, and felons, the Mephistopheles 
and the Tar tuff es. 



CHAPTER VIII 

PSYCHOPATHIC DISORDERS AND PSYCHOPATHIC 
CONSTITUTIONS 

Dementia vs. Amentia. — In the foregoing chapters 
attention has been frequently directed to causes of 
mental deviations and of social failure which are found 
in the province of disturbances in the nervous consti- 
tution and the psychic life of children. Psychopathic 
disorders will explain the difficulties of many cases of 
exceptional development, whether they tend down- 
ward or upward. Even in distinct abnormality we 
must differentiate between dementia and amentia. The 
latter denotes absence of mental endowment of the normal 
human type; the former indicates loss or destruction of 
mental powers which the individual had once possessed. 
Mental defect, therefore, may be one of two kinds: 
either it is the product of disease affecting a potentially 
normal mind, or it is due to lack of development, so 
that an individual does not advance beyond the animal 
or primitive stage. This lack of development, again, is 
twofold in origin; it may be due to hereditary causes, 
predestining a child to perpetuate the defective char- 
acter of its progenitors; or it may be the result of con- 
genital lesions which check the growth of an originally 
normal nervous system. Even after birth, arrest of de- 
velopment may be produced by injury, disease, etc. 
The injury or disease which causes this arrest may be 
physical and physiological, as will happen in accidents, 
or in the weakening after-effects of germ-diseases; or it 

140 



PSYCHOPATHIC DISORDERS 141 

may be psychic, as in the case of overstimulation, grief, 
mental shock, etc. 

In this chapter psychopathic disorders will be dis- 
cussed somewhat in detail. 

Principiis Obsta! (Resist the Beginnings!) — It is a 
great pity that the beginning of these mental derange- 
ments are rarely observed, diagnosed, studied, and 
treated. The great German scholar, Ziehen, speaks of 
" psychopathic constitutions" which can be recognized 
in childhood. Doctor med. Helenefriederike Stelzner, a 
disciple of Ziehen, writes: 

Contemplating all the forms of development of psychopathic 
constitution among school children, we shall readily discover 
among them a great many in which the entire complex of symp- 
toms is at first merely suggested by some form of moral dis- 
turbance; for instance, stubbornness, difficulty of management, 
outspoken ego-centricity, lack of self-denial and self-discipline, 
non-resistance to bodily irritation, moodiness, etc. In dealing 
with these children, should not that kind of education be con- 
sidered most effective which lays greater stress upon moral 
values than upon intellectual and material ones? 

The fact that a good school record and examination certifi- 
cate are very important for success in life, for the struggle for 
existence, induces many to attach too much significance to suc- 
cess in intellectual work and to relegate moral efficiency into 
the shadowy background. The natural egotism of the child is 
not sufficiently counterbalanced; the utilitarian principle is 
pushed to the front. Common rules of school education are 
only too apt to disregard conditions of common advance, and 
to substitute a vainglorious individualistic ambition which 
tempts the child to use his fists and elbows, so to speak, against 
his fellow pupils to secure his own advancement without regard 
to others. This selfish conduct is found in accentuated form among 
Psychopaths. To be kind without receiving praise for it, to 
deny oneself something in the interest of somebody else with- 
out receiving a reward; to show courage in danger without 



142 THE EXCEPTIONAL CHILD 

boasting of it to everybody, and similar ethic attitudes and 
acts are measured too low in the general valuation of conduct 
and progress. . . . This may sound commonplace, and yet 
it is important to point to these things in speaking of abnormal 
children, for the reason that the struggle for existence, which 
becomes more bitter every day, is pushing the threshold of 
consciousness of ethical sentiments ever higher and higher. 

This arraignment of educational mistakes points out 
forcibly a potent cause of psychopathic development in 
children: the under-development of the balancing power 
of ethical standards and emotional discipline. Similar 
truths have been expressed by others. 

Effect of Injudicious Training. — In the attempts made 
by our school systems to adjust themselves to the 
changing needs of modern life, much undue pressure is 
exercised upon the minds of the pupils. Doctor Ber- 
nard Hollander, the famous British alienist, is grievously 
concerned by the sudden increase of insanity in England 
among children under fifteen years of age. He is con- 
vinced that the increased educational demands of the 
present generation and the injudicious training are 
largely responsible for many of the milder forms of 
mental and nervous disorder among school children, 
and he solemnly warns parents and teachers that fre- 
quently the foundation is laid at this period for un- 
soundness of mind in adult years. 

This is a serious warning, indeed, and it shows that 
the problem is practically the same in all parts of 
the civilized world. Doctor J. Victor Haberman, of 
Columbia University, also presents* the fact that ex- 
aminations of the inmates of penitentiaries, prisons, 
and reformatories have shown an alarming percentage 
of psychopathic constitutions; and he has little doubt 



PSYCHOPATHIC DISORDERS 143 

that the majority of these might have been spared had 
they been properly cared for in their youth. This ob- 
servation is also significant in view of the often-made 
assertion that feeble-mindedness is responsible for a 
large percentage of delinquency. 

The beginnings of psychopathic development may, of 
course, lie much further back than the school period. 
There are the hereditary and congenital conditions 
mentioned before. We must also point with earnestness 
to the earliest years of a child's life, when the initial 
and fundamental mistakes are made which may cause 
mental and moral derangement. 

VARIOUS SPECIAL DEFECTS 

Word-Deafness and Word-Blindness. — Many chil- 
dren who are found very backward in reading and 
spelling may be suffering from word-deafness or word- 
blindness. Particularly word-blindness is more com- 
mon among children than is supposed to be the case. 
Word-blind children have normal vision, but cannot 
read the simplest words, or they interpret written or 
printed language only with difficulty. The cause is a 
defect in the visual speech centre in the brain. Re- 
searches into brain structure have informed us of the 
fact that mental and physiological functions are local- 
ized in definite areas of the brain. Defects in these 
areas may impair that particular function without detri- 
ment to the general mental conduct. Word-deafness is 
caused by a similar defect in the auditory speech centre. 
A word-deaf child has no impairment of the hearing 
function as such, but cannot perceive or recognize 
spoken words. A word-deaf or word-blind child has 
this specific defect, just as a child who is really blind 



144 THE EXCEPTIONAL CHILD 

or deaf suffers in these specific provinces of his sense 
life without necessarily being otherwise mentally or 
functionally impaired. 

It will be well to remember what has been said on 
page 125 in regard to anatomical conditions, in the region 
of visual perception, which are causative of excellences 
or impairments in the province of reading and language. 

Speech Defects. — Speech defects: slow and imperfect 
development of the power to speak articulate words; 
impetuous, or indistinct or sluggish speech and similar 
afflictions, may all have their origin in definitely local- 
ized lesions in the speech centres. We know now that 
there is not only one speech centre but that there are 
definite and separate centres for hearing, seeing, speak- 
ing, and writing words. Defects in these centres may 
be born with the child, or they may develop as the 
result of some illness of the nervous system, as they do 
at times in adults. An injury to the head is often the 
cause of alexia (inability to read), agraphia (inability to 
write), or aphasia (inability to name). These impair- 
ments may be total or partial. 

Agraphia Caused by Auditory Defect. — To illustrate 
the complications which may arise in making a proper 
diagnosis of cases, the following most instructive inves- 
tigation may find a place here. Arno Miiller, Leipzig, 
wrote in the Zeitschrift fur Kinder f or schung, November, 
1914, on "Hardness of Hearing as Cause of Apparent 
Agraphia." The following excerpts will show the trend 
of his article: 

Correctness of diagnosis in the matter of a diseased condition 
is the absolute prerequisite of successful treatment, in educa- 
tion as well as in medicine. Many a case in which instruction 
meets with difficulties must be given up by the teacher, because 



PSYCHOPATHIC DISORDERS 145 

he cannot discover the root of the evil, or because he follows 
the wrong course of treatment owing to a mistaken diagnosis. 
Mistaken conclusions are quite frequent, inasmuch as diseased 
psychic phenomena rarely present symptoms which can be 
explained only in one way. . . . 

My observations and experiments concerned themselves with 
three cases of nearly equal pathological phenomena. The boy 
N. (Case 44) became hard of hearing before he had reached 
school age, in consequence of an attack of cerebral meningitis. 
He was able to hear at a distance of two metres, so that an in- 
dependent development of language communication was not en- 
tirely prevented. . . . Later tests showed that of 21 spoken 
single sounds which he repeated correctly, he wrote 9 wrongly. 
Of these same 21 single sounds, when he tried to read them from 
the written copy, he could not identify 6. When 15 syllables 
of two letters each were dictated to him, he could not write 
one of them, even though he had perceived them acoustically. 
Instead of ZA he wrote ENNTO; instead of MA, WIEI; in- 
stead of LA, TARN, etc. He could read only two of these 
syllables. The dictation of the numerals 1 to 10, which were 
perfectly familiar to him as spoken words and in their arith- 
metical value, resulted in the correct reproduction of "eins" 
(one) only. The other reproductions had no connection 
with the number concept whatever. For "zwei" (two) he 
wrote GARNA; for "vier" (four), ZRAM; for "fiinf" (five), 
GARMTA, etc. He could read only " eins " and " drei " (three). 

Almost the same pathological symptoms were observed with 
the boys M. (Case 45) and R. (Case 46), so that I felt con- 
strained to include them in my examinations. M. is congeni- 
tally hard of hearing, while with R. the trouble began at the 
age of 4, after an attack of scarlet fever. In both the trouble 
has not progressed far enough to prohibit the hearing of speech, 
even though it is greatly impaired. . . . 

Further tests established somewhat the same condi- 
tions as previously described for the boy N. 

The long, unsuccessful attendance at school, the presence of 
disturbances in two distinct branches of language communica- 



146 THE EXCEPTIONAL CHILD 

tion, the general inferiority of the mental condition, and the 
etiological features in the three boys suggested the theory that 
we were dealing with diseased conditions, or with complete de- 
generations in the speech-centre region of the cortex. A closer 
study of the defects points to agraphia and alexia. The agraphic 
type represented is apparently motor. . . . The reading dis- 
turbances are identical with the symptoms of pure alexia (word- 
blindness). This consists, after Doctor Romer, in the impos- 
sibility to read words, i. e., to understand the symbolism of letters 
and to grasp them in their connection in words; the patient sees 
with normal vision the optical picture of the individual letters 
and words, but he cannot penetrate into their meaning, the 
written images remain to him meaningless figures, unintelligible 
outlines, as are to the layman the written symbols of a strange 
language like Sanskrit; he can perceive, understand, and name 
all objects optically, but all that is written and printed he can 
only perceive in its outward form, not grasp and denote. He 
can also acoustically perceive, understand, remember, and re- 
produce the sound values of letters and words, only that he 
cannot make proper use of the optical images. It makes no 
difference that the three boys under observation have retained 
the ability to read single letters. For cases have been described 
in which only a limited number of letters was lost. Frequently 
certain especially well-known and early acquired words are still 
correctly interpreted. Also figures are often retained while 
the corresponding number words cannot be read. 

Miiller then reports his investigation of the patho- 
logical condition of the three boys in detail, employing 
for graphic representation the Lichtenheim speech schema, 
which is reproduced on next page. 

Of the results of these investigations the following 
typical statements are characteristic: 

The boys' inability to read and write is caused by the im- 
passability of the association paths 5 and 7. The non-func- 
tioning of path 7 represents a disturbance of the relation be- 
tween optic and acoustic components. The disturbance of 



PSYCHOPATHIC DISORDERS 



147 



path 5 produces a separation of the writing motor centre from 
the speech motor centre. . . Doctor Romer connects the sound 
motor agraphia with diseases of the motor speech centre. The 
same effect is produced if the association fibres issuing from M 
are disturbed. External symptoms and inner localization of 
the morbid phenomena in the three boys point therefore to 
agraphia and alexia. . . . 






Y Y 

T A A 

Fig. io. 
Lichtenheim speech schema. 
C = word meaning centre; SA = acoustic centre; M = speech motor centre; 
O = optic centre; E = writing centre; i, 4, 8, and 9 = paths of projec- 
tion; 2, 3, s, 6, 7, and 10 = paths of association. 



The causes, however, need not be anatomical. 

Reading and writing are faculties which can be acquired only 
by systematic pedagogical training. The cause of the distur- 
bance may, therefore, also be looked for in a neglect of the func- 
tional exercise of the association tracts which was the result of 
the children's special nature ox of the character of the methods of 
instruction employed. . . . 

This latter assumption was corroborated by further 
careful investigations. It was found that their hardness 
of hearing had vitiated the normal functioning of the 
boys' speech centres, and that thus the diagnostic prob- 



148 THE EXCEPTIONAL CHILD 

lem was solved, and the problem of special training and 
relief became evident. The three boys responded slowly 
but surely to the treatment prescribed, thus proving 
that they did not represent cases of pure agraphia and 
alexia, but plainly the effect of their hearing defects. 
Miiller closes his remarkable statements with these 
sentences: 

The result of our investigation is the demand that all children 
in whom dejects in reading and in written expression are observed, 
should be carefully examined as to their faculty of hearing. As 
soon as the slightest degree of hardness of hearing is detected — 
be its effect upon spoken language ever so minimal — this defect 
is to be considered as the primary cause of the disturbance, 
before the assumption of speech-centre defects or of general feeble- 
mindedness is justified. An unsuccessful treatment of this class 
of children will then be a rarer occurrence. 

Stammering and Stuttering are speech defects which 
have little or nothing to do with the brain centres, but 
are either the result of imitation and habit, or peripheral 
affections caused by nervous and psychic disturbances. 
In these cases the neurologist is the proper adjunct of 
the educator in the matter of treatment and eventual 
relief. 1 

Defects of Number Conception. — Localized defects 
seem to exist in the sphere of number conception, also. 

1 Doctor William Browning, in a thorough study of stammering, comes 
to the conclusion that it is not primarily a disorder of the central nervous 
system. Nor is it an isolated, freak, or just functional affair, but is 
always at the start a symptom and part of a wide-spread or systemic 
condition. This general condition is a phase of hyperthymism (excessive 
activity of the thymus gland, at the base of the tongue), closely allied 
to or part of that known as lymphatism. Scripture and Glogau, in a 
recent study of stuttering, find that "speech conflict," i. e., the conflict 
between the home and school language of immigrant children, is an 
important etiological factor. 



PSYCHOPATHIC DISORDERS 149 

Of course, the three impairments mentioned before 
(alexia, agraphia, and aphasia), and also defects in the 
motor centres have their bearings upon the handling of 
numbers in their spoken or written form. Some chil- 
dren, on the other hand, can do the abstract work in 
arithmetic in the school pretty well, handling figures 
and other number symbols with alacrity. Yet they 
may be found to have no real conception of number 
values. The psychology of number is still in its in- 
fancy. Reference may be made here to Chapter VIII, 
of the author's book, "The Career of the Child," treat- 
ing of the mathematical evolution of the child. The 
counting process, it is shown there, is distinct from the 
space concept in number; space and quantity are re- 
lated concepts. There is also, connected with counting, 
the element of rhythm and repetition. 

In a measure, the handling of numbers seems to de- 
pend upon a physiological mechanism which we do not 
yet understand. Reference has been made in the pre- 
vious chapter to the feeble-minded lightning calculators. 
Memory, visual and aural, plays a great part in these 
abilities. Some individuals, otherwise not at all intelli- 
gent, possess the blessed gift of an excellent mechanical 
memory which serves them as an almost automatic tool. 
Observations point toward the pre-eminently visual 
character of this mechanical memory; in other words, 
these individuals visualize with readiness and precision^ 
The time element in these processes is a curious thing. 
To the conscious mind time is a succession of conscious 
units. But it depends largely upon emotional states 
how this time element will manifest itself. Short periods 
of time will appear unbearably long to the impatient, 
the grief -stricken, the sick; and it has already been 



150 THE EXCEPTIONAL CHILD 

shown how under stress of excitement a person may 
seem to live through experiences of years in a single 
moment. It is therefore thinkable that similar com- 
pressions of the units of time occur in the lightning-speed 
calculators, whether they are feeble-minded or not. 

Memory Defects. — Conversely, weakness of memory 
power induces failures in conscious school work. Many 
of the author's own cases have shown the cause of their 
lack of school progress to be their inability to retain 
visual and aural units in their memory; they fail, either 
as to the number and order of the units presented, or 
in the length of time during which they are remem- 
bered. The short visual and aural memory span is 
characteristic of many backward children. 

So-called logical memory, that is to say the faculty 
of consciously associating and organizing units for the 
purpose of retention is, it would seem, dependent upon 
the physiological mechanism of memory. Through 
proper exercises in quick observation, concentration, 
and memorizing, a weak memory can be strengthened, 
just as a weak muscle can be improved by exercise. 

Clinical Studies. — It is of the greatest importance 
that the psychic functions of the child should be clini- 
cally studied. Knauer suggests special tests, (i) in the 
ability to profit from exercise and repetition; (2) in 
mental fatigue; (3) in the effect of recuperation and 
of rest pauses, and (4) in the elementary conception 
of sense-impressions (content and time). He asserts 
riglitly that these functions are of much more funda- 
mental nature than the intellectual possessions of a 
child. Ordinary intelligence tests, such as the Binet 
Tests, may give the same results in very different indi- 
viduals without disclosing the genesis of the results. 



PSYCHOPATHIC DISORDERS 151 

Psychopathic conditions are frequent in the group of 
children which the author has described as "atypical." 
The fourth group of exceptionally bright children, as set 
forth in the previous chapter, belongs to the same cat- 
egory or, rather, is one of the groups comprised in the 
term "atypical." 

Dementia Precox. — Mention should be made here of 
the affection which is familiarly known among neurolo- 
gists under the name of "dementia precox," and which 
really represents a confusing group of symptoms of the 
psychasthenic type. The precursor of this disease is 
now called predementia precox and is, as Doctor Adolf 
Meyer has shown years ago, very amenable to educa- 
tional treatment. It is characterized by extreme forms 
of self-centredness and self -repression, so that the child 
soon finds himself to lead a double life. Several of the 
cases cited in the previous chapter, particularly those 
of A. S. (Case 42) and H. H. (Case 43), were of this 
type. Here, as in all cases of psychopathic nature, the 
co-operation of the skilled psychiatrist is needed. 

Cases of this kind represent no longer mere isolated 
psychopathic conditions or symptoms, but lead over 
to the "psychopathic constitutions," as Ziehen has 
called them, or the "psychopathic personalities," as 
they have been called by others. In most of these, of 
course, it may be assumed that the trouble started from 
some particularly vulnerable point. 

Sexual Neurasthenia. — During the period of pubertal 
development, there is danger of the appearance of 
sexual neurasthenia. In this period the unorganized and 
often excessive promptings of the sex instinct inject 
themselves into all other mental activities, causing emo- 
tional strain and neurotic disturbance. The sex in- 



152 THE EXCEPTIONAL CHILD 

stinct at this time in a child's life is extraordinarily pow- 
erful. The youthful character is not yet strongly 
enough fortified to withstand these excitations which 
occur in all parts of the sexual tract, and which are 
often enough abnormally stimulated by transmitted 
sensations from other functional groups or through vari- 
ous kinds of emotional states. Thus, the overpowering 
instinct which is often subjected to clearly defined 
periodic changes drives the child into a life of storm 
and stress which may, and in no small number actually 
does, lead to masturbation, sexual perversion and in- 
version, crime, and prostitution. Ethics and morality 
are in danger of suffering shipwreck under the impetus 
of these sweeping impulses, which may produce, in 
neurasthenically inclined individuals, a distinct type of 
pathologic deviation : sexual neurasthenia and sexual pre- 
cocity (cf. case of H. H. (Case 43), mentioned in previous 
chapter). Lying and deceiving, slander, intriguing, and 
theft, a morbid desire for alcohol and tobacco, are 
symptoms of a perverted sex instinct, or of one which 
is in danger of perversion. Even in the development of 
youthful hysteria puberty marks the time which decides 
the significance of this disease for the life of the child 
suffering from it. There may be observed depressive 
manias, fixed ideas, obsessions, morbid fears, forced 
actions; epileptic symptoms may appear or true epi- 
lepsy may develop either in its motor or in its psychic 
form. 

Other Psychopathic Symptoms. — In the previous 
chapters reference has been repeatedly made to various 
psychopathic symptoms. There are conditions of ner- 
vous fatigue, of timidity, of negativism (which must be 
differentiated from mere disobedience, which latter is 



PSYCHOPATHIC DISORDERS 153 

merely a matter of habit training), and many other 
mental states which are psychopathic in character. We 
may observe manifestations of disproportionately strong 
reactions to stimuli and impressions such as pain, tickling, 
etc. ; of subjection to frights and terrors, and those dis- 
turbances of the psychic equilibrium as in "tantrums" 
and fits of temper, which are almost maniacal in form; 
also vivid sensory illusions, hallucinations, and the like. 
Further, we have the restless sleep, the excessively vivid 
dreams, the awakening in alarm, with crying and kick- 
ing, or even sleep-walking (somnambulism). There are 
also the strange fears 1 and obsessions which induce the 
child to be afraid of getting dressed or undressed, of 
having water touch him, or of being touched by a 
stranger; of walking across an open square or field, or 
of being in the dark; the horror of noises or of stillness; 
of being with other children, or of being alone; and 
many other strange idiosyncrasies. Then there are the 
" habit spasms" mentioned in a previous chapter, also 
called "tics," like shrugging and jerking, the tendency 
to tear and soil and destroy things, etc. These mani- 
festations may be merely occasional or transitory, and 
then they are counted among the so-called "bad habits" 

1 Arthur J. Westermayr, in his book, "The Psychology of Fear," says: 
"Reference should be made to certain abnormal forms of fear for which 
no excuse can be offered except that they are congenital and perhaps due 
to antenatal states of the mother; severe fright of the mother is known 
to mark the child by an unnatural sensitiveness to certain kinds of dan- 
ger. As abnormal appetites are thus created, so an unnatural fear may 
be born in the offspring." The author is not inclined to think that 
Westermayr's view is tenable in all cases of strange and apparently un- 
accountable fears, if it is tenable at all. Some fears are indeed inherited, 
but not in the way Westermayr assumes, but as reverberations of pri- 
mordial experiences of our remote ancestors. In this class belongs the 
fear of snakes, spiders, water, etc. 



154 THE EXCEPTIONAL CHILD 

which are often enough perfectly natural outcroppings 
of instincts normal for the developmental period through 
which the child passes at the time; these will be lopped 
off by the natural process of growth and by educational 
influences. But when the child's conduct is distinctly 
pathological, the early advice of experienced specialists 
in education and psychiatry is required. 

Children who suffer from vasomotor disturbances (those 
nervous affections which appear in the circulatory sys^ 
tern) exhibit rapid changes of color in the face (flushes 
and pallor); hands and feet "fall asleep" on the least 
provocation, or are chronically cold and clammy. 
There are also disturbances in the centre of balance; 
these lead to dizziness and nausea when the child is in 
a rapidly moving vehicle, in a train, a swing, etc. Many 
children lack the power of self-control and inhibition, 
of concentrated attention, and are characterized by 
the constantly changing intensity of their work and 
application. They are irritable, morose, and "ugly," 
these moods quickly alternating with states of happi- 
ness and a readiness to apply themselves joyfully to 
any task before them. These phenomena do not indi- 
cate "naughtiness," but nervous disease. 

Likewise we have disturbances in the digestive appa- 
ratus {trophic disturbances) which are strictly of a ner- 
vous character, such as nervous dyspepsia. They can 
be cured only by reaching the nerve centres which con- 
trol the alimentary system. 

Illustrative Cases. — Farnell mentions the following 
cases, "offering such traits as lack of affection, uninter- 
estedness in work at school, absence of desire to play, 
inattention, idleness, fearfulness, irritability, 'dreami- 
ness,' and evident difficulty with the sex problem. 



PSYCHOPATHIC DISORDERS 155 

There is no doubt but there is an internal conflict, long- 
ings or desires that influence this type of mental aber- 
ration. This is produced without any disturbance of 
the will and often without the child being conscious of 
the source of the influence. It is not uncommon in 
every-day life to forget names, incidents, and so forth, 
also to make mistakes in reading and writing and do 
thoughtless acts, all of which have a direct connection 
with our mental trends. These are not accidental, but 
actual, and can be traced back to an attempt, instinc- 
tively, to forget unpleasant experiences or to complete 
a desire by a more ethical process." 

Doctor Farnell cites a number of examples, of which 
a few may be here quoted. 

Let me refer to a boy of 12 years (Case 47), whose father 
died following a stroke and whose mother is alive and well. 
One brother committed suicide at the age of 16 years. He 
was of normal birth and has never had any serious illnesses. 
Nothing wrong was noticed until about two years ago, when he 
became abnormally quiet, was easily irritated, tired out, and 
laughed without apparent cause. At school his teacher noticed 
a great change: he was "lazy," not attending to his work, and 
showed complete loss of interest. He had no playmates, avoided 
both sexes and remained entirely by himself. Occasionally he 
would attend a lecture at the Park Museum. A few months 
ago he began making peculiar movements with his hands and 
face, would talk to himself and pace back and forth in the yard. 
He told his mother that life was a burden, not worth the while, 
and that he thought he would end it all. His intellectual tests 
were correct and there were no physical disturbances. This 
child has apparently been unable to square himself with the 
difficulties in life. Let me say that a great many children may 
show the same set of traits as the above, and possibly you may 
know personally children who are seclusive, quiet, non-mixers, 
and so forth. But it is not that alone that completes the pic- 
ture, and again I may say that these symptoms given above 



156 THE EXCEPTIONAL CHILD 

may offer a warning and suggest timely care, and instruction 
may prevent its development. 

My next case is that of a girl of 16 years (Case 48), whose par- 
ents are alive and well. One maternal aunt and several cousins 
were insane. She is the third in a family of five. Nothing ab- 
normal about her birth or early infancy, except that at an early 
age she was considered "nervous." She began school at the age 
of 6 years and progressed fairly well the first three or four 
years. She then became what the parents called "lazy," cried 
a great deal and didn't seem to be able to keep her mind on 
her work. At 13 she passed through puberty, with its wrench- 
ing and nerve-wrecking forces. She then became nervous, se- 
clusive, quiet, non-confiding, and at the same time somewhat 
inquisitive and curious. She cried almost constantly and 
evinced marked vasomotor disturbances, such as coldness of 
the hands, lividity of the arms, and so forth. She had attacks 
of anger and occasionally the nightmare. At school she lagged 
behind in her class and appeared to be further handicapped by 
her comparison with others and her feeling of being at a disad- 
vantage, as indicated by her apparent intellectual weakness. 
Physically she evidenced entirely vasomotor phenomena. In- 
tellectually she is inferior, but she is not feeble-minded, and 
there is some question as to whether or not she might be in- 
sane. At all events, there is a pronounced evidence of prede- 
mentia precox. The question arises, Why her intellectual slow- 
ness ? What can be done ? Shall we allow her to fail and, as 
will undoubtedly follow, become insane? 



Here the problem is squarely stated. A comparison 
of Farnell's cases with those quoted from the author's 
own records is invited. Impaired efficiency of psycho- 
logical function is quite common in children. A solu- 
tion of the difficulty presented may not always be 
ready, but a proper analysis of a child's mind is obvi- 
ously the first step toward the removal of nervous 
symptoms. A number of cases belonging to this class 
were reported to the "American Psychopathic Asso- 



PSYCHOPATHIC DISORDERS 157 

ciation" by Doctor Tom A. Williams, of Washington. 
Their study is illuminating. Here are a few selec- 
tions : 

One of these, a girl aged 8 (Case 49), was kept from school; a 
simple analysis lasting half an hour revealed that the child had 
become overscrupulous from injudicious teaching of physiology. 
The condition was rectified, she was sent back to school, and is 
now perfectly well. 

The ardent affection of another little girl (Case 50) was mistak- 
ingly repulsed by the parents, which led to a melancholia. After 
eight hours' analysis she was cured in two weeks and restored 
to the class of normal children. 

A boy of 14 (Case 51) had developed since 3 a jealousy of a little 
brother which caused such shame that he devoted half his time 
to penances, the meaning of which was unknown to his relatives. 
An hour's analysis and four re-educative sittings sufficed to trans- 
form his character and turn him toward useful activities. 

All these were cases of poor adaptation, which was supposed 
to be due to inherent nervousness, more or less hopeless. Yet 
they were merely the result of faulty handling and required 
only a proper comprehension of their psychological constitution. 

All were the children of people of superior attainments and 
conscience. 

From the author's own practice numerous cases of 
children 1 might be added that were saved by removal 
from their environment into a sane and natural educa- 
tional atmosphere, with much fresh air, light, and sleep, 
simple, nourishing food, regular exercises, manual and 
occupational work and a modicum of "school lessons" 
presented in a manner to stimulate the child's interest 
and to distract him from his morbid, self-centred moods. 

1 Figure 33 represents a free-hand drawing, illustrating a story, by a 
psychopathic boy of 14 (K. B., Case 52). The work shows very good 
conception, skill and action, considering the boy had had no training. 
This talent was utilized as a point of vantage in redeeming the child. 



158 THE EXCEPTIONAL CHILD 

Self-centredness and lack of spontaneity are among the 
most obvious symptoms in a psychopathic constitution. 
Much of positive suggestion toward higher social and 
mental ideals and ambitions, and toward genuine self- 
realization is needed. 1 

The Educational Clinic. — The only practical way of 
detecting psychopathic conditions in children is through 
organized co-operation of school and home. The family 
physician should be a careful adviser, and the school 
physician a ready and determined diagnostician. Ob- 
servations in an educational clinic, such as ought to be 
connected with every school system, in conjunction with 
medical inspection, and which will be described in the 
second part of this book, should be supplemented by a 
careful detailed study of the child of this type by an 
experienced psychiatrist at a psychopathic clinic. 

1 Doctor Louis E. Bisch, in a recent article, calls attention to the fact 
that Charles Lamb (Case 53) suffered from an attack of insanity in his 
early life, and this is what he wrote to Coleridge: "At some future time 
I will amuse you with an account ... of the strange turns my frenzy 
took. I look back upon it at times with a gloomy kind of envy, for while it 
lasted I had many, many hours of pure happiness. Dream not, Cole- 
ridge, of having tasted all the grandeur and wildness of fancy till you have 
gone mad. All now seems to me vapid, or comparatively so." 



CHAPTER IX 

THE FEEBLE-MINDED GROUP 

Vagueness of Definition. — Feeble-mindedness has been 
studied widely of late, so widely, indeed, that its study 
has overshadowed consideration of other mental difficul- 
ties to an enormous degree, much to the detriment of sci- 
entific accuracy and progress. The most remarkable fea- 
ture of this study, however, is that it has not yet led to 
any clear-cut definition of what feeble-mindedness is. 
And this is curious if we remember that normality, too, 
has never before been clearly defined, except by negative 
terms. These facts show beyond the shadow of a doubt 
that the field of this study is yet very backward in cul- 
tivation, and that we are still dealing with practically 
unrelated facts. We must wait until, after the passing 
of generations, we have gathered a sufficient store of 
really scientific data, data of exact observation, from 
which to draw conclusions which are tenable. All de- 
ductions as yet made are tentative only, some very 
ambiguous, even fallacious; and many of them are 
based upon opinions, not on absolutely established facts. 

Professor C. B. Davenport, of Cold Spring Harbor, 
speaks of the "vague class of the 'feeble-minded' — the 
incapable." Miss E. E. Farrell, in her discussion of 
the Goddard report on ungraded classes in New York, 
says: "We do not know what is meant by a feeble- 
minded child." Terman, in his review of the Meumann 
tests, writes: "It would seem that our concepts of feeble- 
mindedness still rest largely upon tradition, In their 

159 



160 THE EXCEPTIONAL CHILD 

characterization of different grades of mental defects 
psychologists are still prone to fall back upon the crude 
descriptions found in the earlier medical literature. In 
short, the psychology of mental deficiency needs to be 
entirely revised." 

Doctor H. H. Goddard, in his recent book, "The 
Criminal Imbecile," contributes these statements to the 
definition of an "imbecile": 

There are various ways of designating this type of individual. 
Imbecility, as used in law in this country, may be defined as "the 
state of mental defect existing from birth or from an early age, 
due to incomplete cerebral development, in consequence of which 
the person affected is unable to perform his duties as a member 
of society." The high-grade imbecile . . . feeble-minded, as he 
is called in England, or the moron, as we are coming to call him 
in the United States, is one who is "capable of earning a living 
under favorable circumstances, but is incapable from mental de- 
fect, existing from birth or from an early age, (a) of competing 
on equal terms with his normal fellows, or (b) of managing him- 
self or his affairs with ordinary prudence." These definitions 
were formulated by the Royal College of Physicians in England, 
and accepted by the Royal Commission on the Care and Con- 
trol of the Feeble-Minded. 

These definitions tally in a measure with the author's 
own contention, as stated in various places in this book, 
except that "competition on equal terms with his nor- 
mal fellows" is a somewhat ambiguous term. These 
"equal terms" bear further scrutiny. 

But it is interesting to note in Doctor Goddard's 
statement that he practically abandons the grouping of 
the feeble-minded in three distinct groups, as has been 
customary for some time in this country, viz. : the groups 
of the idiots, imbeciles, and morons. He combines the 
two latter classes in one and ascribes to them a "mental 



THE FEEBLE-MINDED GROUP 161 

age" of from three to twelve years. The high-grade 
imbecile, according to this modification of terminology, 
is the moron, another example of variation in the use 
of terms. 

Amentia vs. Dementia. — Feeble-mindedness has often 
been confused with psychopathic conditions. A good 
presentation of the difference between feeble-mindedness 
(amentia) and normality, on the one hand, and psycho- 
pathic states (dementia), on the other, is contained in 
A. F. Tredgold's work on "Mental Deficiency." He 
says, in part: 

The essence of mental defect is that it is incurable, and by no 
"special" education, however elaborate, can a case of amentia 
be raised to the normal standard. Some defect must always 
remain, and upon this fact all authorities agree. . . . 

It is not, however, to be assumed that amentia is merely a 
subtraction in varying degree from the normal. Although the 
contrary might be thought, nevertheless the two conditions do 
not merge into one another, and between the lowest normal and 
the highest ament a great and impassable gulf is fixed. While 
the former is heavy, stolid, and uniformly dull-witted, he has 
yet sufficient common sense to look after his interests and hold 
his own in that environment in which Nature has placed him. 
The mildest ament, on the other hand, may show no apparent 
dulness; he may even be bright and vivacious, and in some of 
his abilities be immeasurably superior to the clodhopper. But 
the other faculties of his mind are not present in like proportion. 
Instead of harmonious working there is discord, and in posses- 
sion of that essential to independent existence — common sense — 
he is lacking, and the want can never be supplied. 

Mental defect occurring subsequently to mental development 
may be compared to a state of bankruptcy, and is more fittingly 
described as dementia (de, down, from; mens, mind); while the 
person whose mind has never attained normal development may 
be looked upon as never having had a bank account, and this 
state is designed amentia (a, without; mens, mind). In both of 
these, of course, there is literally mental deficiency. 



162 THE EXCEPTIONAL CHILD 

These distinctions tally well with the argument pre- 
sented in previous chapters of this book. 

Feeble-Mindedness vs. Retardation. — Oftentimes, in 
speaking of feeble-minded, the mistake is made of con- 
fusing retarded with arrested development. Goddard is 
therefore right when he claims that "mental age" can 
only be determined "after the stopping-point came." 
The warning which the late Doctor E. B. Huey has 
given in his book on "Backward and Feeble-Minded 
Children" should be carefully heeded: 

In spite of Binet's suggestion and practice the terms idiot, 
imbecile, moron, and feeble-minded will continue to be thought 
of as terms of final diagnosis, and it is probably best not to use 
them when the child gives promise of developing much beyond the 
limits of mental age implied by the term in question. This practice 
is especially advisable if the child is quite young. In these latter 
cases he should simply be recorded as mentally "retarded" in the 
degree found, with such other terms as best describe his actual condi- 
tion. 

It will be found that the term feeble-minded cannot always 
be applied to children, especially to children under fifteen, from 
the mere fact of their showing any given amount of intellectual 
retardation as measured by any scale of tests. Usually, it is 
true, when the child shows more than three years of retardation, 
it is feeble-minded (? G.). But there are cases in which the in- 
telligence is inhibited even to this extent in functioning or in 
development, from causes whose removal permits the child to 
prove that he was never of the feeble-minded kind. On the 
other hand, I shall later present notes of many cases showing 
less than three years of retardation, but which are undoubtedly, 
and some of them very fundamentally, feeble-minded. As a 
matter of fact, all psychiatrists know that feeble-mindedness. 
like insanity, involves much more than intelligence, and its cor- 
rect diagnosis often involves the expert consideration of various 
clinical phases, and cannot be made by the automatic applica- 
tion of any schema or scale. It is evident, however, that diag- 
nosis may be greatly facilitated and in the majority of cases 



THE FEEBLE-MINDED GROUP 163 

may be practically accomplished by a careful measurement of 
the intelligence. 

These interesting suggestions show, however, that 
Huey confuses the two categories so clearly stated by 
Tredgold — the dull and the aments. It might recom- 
mend itself to substitute in the future the term "ament" 
for "feeble-minded," as the latter term is really, in its 
etymology, too ambiguous, and may be applied with 
equal justice to various classes of lower intelligence. 

The difference may also be stated in the following 
manner: 

Arrest of development is a condition which precludes 
further mental growth. It is parallel to the condition 
which prevents physical growth after the so-called full 
growth has been attained. This stoppage of physical 
growth, by the way, is not a complete one, and we may 
voluntarily affect it by certain measures. Likewise, 
while we may speak of "mature" mentality in the sense 
of a finality which would seem to imply a stoppage of 
further mental growth, the normal individual in reality 
preserves the faculty of intellectual growth until his 
death, unless a pathological "arrest" takes place earlier. 
Arrest of mental development, then, means that the 
mind has reached its absolute limit, beyond which there 
is no further growth. Such arrest may be caused by 
many different things. There may be hereditary and 
congenital causes ; there may be illness or injury (trauma) ; 
in some cases the real cause may remain obscure. Fee- 
ble-mindedness is a case of prenatal arrested develop- 
ment; no amount of training will lift the mind of a 
feeble-minded person above its stationary level. As said 
before, feeble-mindedness is the result, in a measure, of 
"unfinished" foetal development; children of this type 



164 THE EXCEPTIONAL CHILD 

exhibit definite evidences that neither their bodies nor 
their "minds" have completed the normal intrauterine 
growth, which also passes through more or less defined 
stages (Haeckel's parallelism between "phylogeny" and 
"ontogeny"). But arrest may occur at almost any 
stage of an individual's life, so that its condition is not 
identical in all cases, and its levels are widely different. 

Retardation, on the other hand, is dependent upon 
individual rhythm and rate of growth, or upon oppor- 
tunities which affect growth. It may vary in its rate 
at different periods of a child's development, periods of 
slow growth alternating with others of faster progress, 
mentally as well as physically. In extreme cases of 
retardation, when the cause is an excessively slow men- 
tal growth rate, or when external retarding influences are 
very powerful, the line between retarded and arrested 
development may be difficult to draw; but the occur- 
rence of such cases should not vitiate the general argu- 
ment. 

Among the accidental and external causes of retarda- 
tion the physical handicaps play an important part. 
Economic conditions and malnutrition have their sinis- 
ter influence. It has been shown that the children of 
districts like the Chicago stock-yards or of the tenement- 
house slums of our metropolitan cities are invariably 
the victims of retarding influences. Other causes are 
temperamental, others racial. Among the children of 
our immigrants temporary retardation is caused by un- 
acquaintance with the language, custom, and spirit of 
the land. 

Causes of retardation not so patent and rarely dis- 
cussed must tje found in those serious conflicts to which 
many of our children are exposed. There are conflicts 



THE FEEBLE-MINDED GROUP 165 

in the home: different standards of discipline employed 
by father and mother; emotional tensions due to dis- 
sensions in the family circle, which throw the child into 
conflict between himself and either parent, or brothers, 
sisters, and other relatives. Often there is a grave con- 
flict as to whether the home is maintained as a home 
for the child, or for the adult members of the family; 
and usually the child is sacrificed to the comfort of the 
adults. There are conflicts between the demands of 
the home and those of the school; conflicts between 
school standards in different communities, or within 
single schools of the same district. There are conflicts 
between the moral standards of communities and those 
of the child's home or church. There are conflicts be- 
tween the physical, mental, and emotional forces within 
the child's own personality, and many other conflicts in 
which the child either loses or barely keeps up the 
game. All these are contributory to retardation. 

Inadequacy of " Mental Age." — Of the Binet tests 
further mention will be made in a later chapter. At 
this time it may merely be stated that none of the 
author's distinctions are made upon the basis of Binet's 
grouping by what is called "mental age." The term 
"mental age" is supposed to indicate the mental capac- 
ity of the individual as compared with that of a child 
of that age. Thus, if the mental age of an individual 
is given as 7 years, it means that his mentality is equal 
to that of a normal child of 7. "Each mental age rep- 
resents the abilities of the normal child of the corre- 
sponding chronological age." (F. Kuhlmann, in Journal 
of Psycho- Asthenics, June, 1913, p. 134.) 

In this way the feeble-minded have been grouped so 
that individuals are called idiots if their mentality does 



166 



THE EXCEPTIONAL CHILD 



not exceed the mental age of 2 years. Imbeciles are 
those whose mentality corresponds to the normal men- 
tality of children from 3 to 7 years of age. The men- 
tality from 8 to 12 years is ascribed to the group called 
morons. The mental age of a moral imbecile has been 
stated to be 9 years, representing arrest of development 
at that stage. 

How utterly inadequate such a grading is, in com- 
parison with normal mentality, becomes evident at once 
by looking at the following table, which is quoted from 
a publication on the "Organization and Management of 
Auxiliary Classes," by Doctor Helen MacMurchy, In- 
spector of Auxiliary Classes for Ontario. 



Mental 


Industrial Classification 


Grade 


Age 






Under i 


(a) Helpless, (b) Can walk, (c) With volun- 




year 


tary regard 


Low idiot 


1 year 


Feeds self. Eats everything 


Middle " 


2 years 


Eats discriminatingly 


High " 


3 years 


No work. Plays a little 


Low imbecile 


4 years 


Tries to help 


It a 


5 years 


Only simplest tasks 


Middle " 


6 years 


Tasks of short duration. Washes dishes 


High " 


7 years 


Little errands in the house. Dusts 


U t( 


8 years 


Errands. Light work. Makes beds 


Low moron 


9 years 


Heavier work. Scrubs, mends, lays 






bricks, cares for bathroom 


U «( 


10 years 


Good institution helpers. Routine work 


Middle " 


11 years 


Fairly complicated work with only oc- 






casional oversight 


High " 


12 years 


Uses machinery. Can care for animals. 






No supervision. Cannot plan 


M a 



Any one familiar with a really normal child of any 
of the ages given will at once be convinced that it is an 
injustice to him to compare his mentality with that of 



THE FEEBLE-MINDED GROUP 167 

the corresponding degree of feeble-mindedness. We 
may even say it is an insult to compare the duller nor- 
mal individuals, with their circumscribed abilities, such 
as Tredgold speaks of, with the morons who are doomed 
to standstill. Quite apart from the factor of growth 
which distinguishes the normal child, and the dull child, 
from the feeble-minded individual, there is such a differ- 
ence in the mental fibre, in the intellectual efficiency, 
and in the actual life conduct that the comparison can- 
not be tolerated. Any system of testing and grading 
based upon this conception involves a fallacy. Even 
the differentiation of periods of development or "cul- 
ture epochs" such as has been suggested in the author's 
system of tests has its drawbacks. But in the light of 
what has been set forth in various places in this book 
about the general principles of child development, 
through consecutive periods of physical and mental 
growth, the author would seem to be justified in pre- 
senting this method of grouping and grading as approxi- 
mately true — certainly truer than the "mental age" 
method. 

It is encouraging that this view is penetrating even 
into the camp of the Binet advocates. In the June, 
1 91 5, issue of Ungraded, a new magazine devoted to 
the interest of the "exceptional" child (the author of 
this book acknowledges with thanks even this accep- 
tance of his terminology!), Frederick W. Ellis, Director 
of Social Research at the New York Neurological Insti- 
tute, admits that "both 'mental age' and 'physiological 
age' are to be regarded from the point of view of physi- 
cal growth periods, rather than in the more precise terms 
of months and years." As the most usable age limits 
he gives these: "Early childhood, 5 to 8 years. Later 



168 THE EXCEPTIONAL CHILD 

childhood, 9 to 11 years. Preadolescence, 12 to 14 
years. Early adolescence, 15 to 18 years. Later ado- 
lescence, 19 to 28 years." A comparison of this sched- 
ule with the one suggested by the author is instructive. 
But now comes the strange faith in the usability of the 
Binet Tests even for this schedule. Says Doctor Ellis: 
"In practice we have found the Binet and Simon Tests 
most characteristic of the later childhood period (9 to 
11 years!) to be the 7-year tests; of the preadolescent 
period (12 to 14 years!) to be the 9-year tests; and of 
the early adolescent period (15 to 18 years!) to be the 
10-year tests. To be fully established in one of these 
periods the subjects must pass all of the tests assigned 
to it." The italics in parenthesis are the author's. It 
is difficult to see where the line must be drawn in stretch- 
ing the Binet Tests to suit individual investigators. 

Or would Doctor Ellis's findings imply that American 
children are away behind French children in intellectual 
standards ? 

In his book on criminal imbeciles, quoted before in 
this chapter, Doctor Goddard gives an interesting ex- 
ample of the fallacy of arguing in a circle. He says: 

We may further designate this type of individual (the imbe- 
cile) by saying that he has the mentality of a normal child of 
from 3 to 12 years of age. These age limits have been deter- 
mined by examining thousands of the inmates of institutions 
for the feeble-minded, and comparing them with normal children. 
The inmates of the institutions are there because they were not 
capable of managing their own affairs with ordinary prudence, 
because society has discovered that they could not take care of 
themselves; they are weak-minded; they must be cared for by 
the public. Careful examination of such persons as have been 
determined by experience to be incapable of managing them- 
selves shows that they range in intelligence, as before stated, 



THE FEEBLE-MINDED GROUP 169 

from 3 to 12 years. There are practically none in these insti- 
tutions that have a mentality above 12. Those under 3 are 
called idiots. 

We shall omit, in this connection, to question the re- 
liability of the discovery, by "society," that all these 
inmates of institutions were really unable to take care 
of themselves, even if given the right opportunity; we 
shall not discuss the tacit admission that there are, in 
these institutions, persons who test above 12 — an ad- 
mission which vitiates the argument in some measure. 

But let us remember that the determination of " men- 
tal age" as the term is here used, was made by the appli- 
cation of the Binet Tests. They were used with persons 
who had been set aside by "society" as imbeciles — for 
reasons which "society" thought were sufficient to so 
designate them. These imbeciles, if they were imbe- 
ciles at all, reacted in a certain way to these tests. Then 
these findings are used to judge of others, not yet in 
institutions, to determine their mentality, to eventu- 
ally diagnose them as imbeciles if they continue to 
test below 12 by the application of these same tests. 
The question arises: Why the need of these tests if 
"society" has already other means to "discover" the 
imbecility of those it has already segregated? And if 
these other means are inadequate, how is it that the 
findings of "society" should be taken as a basis for the 
application of the new tests? 

This manner of arguing reminds one forcibly of the 
well-known example of logical fallacies, often presented 
in text-books on logic, by which the existence of God is 
proven from the truth of the Holy Scriptures, and then 
the inspiration of the Scriptures is proven from the fact 
that they came from God: 



170 THE EXCEPTIONAL CHILD 

As the Scriptures are the word of God, what they declare 
must be true. The Scriptures declare that God exists. There- 
fore, that God exists is true. 

The use of any one set of tests, like the Binet, in the 
manner suggested by their advocates, is like using, say, 
an acid test in chemistry. This acid test means just 
what it is: a method of determining the acidity of a 
certain substance, nothing more. This may be a help 
in determining the nature of that substance, but alone 
it can never assist us in differentiating between, e. g., 
water, gastric juice, milk, and a hundred other liquids. 
Likewise the Binet Tests, in their application to human 
minds, tell just as much as they can tell, but they do 
not allow the far-reaching conclusions which have been 
made by many of their advocates. As stated on page 
150, such tests may give the same results in very differ- 
ent individuals without disclosing the genesis of the 
results. 

Feeble-Mindedness vs. Primitiveness. — If we con- 
sider intelligence to mean a capacity for mental work, 
it is evident that one may learn a great many things 
within the limitations of such capacity without improv- 
ing one's intelligence. Or, as has been shown before, 
we may raise the performance level of any given task 
without doing more than improving skill. Thus, God- 
dard is right when he defines feeble-minded children to 
be such as "are trainable, but not improvable in intel- 
lectual capacity." This would, however, necessitate a 
distinction between primitives and feeble-minded, inas<- 
much as primitives may possess a rather high intelli- 
gence, even though it be on a low performance level, 
the individual increment to community needs being 
small. 



THE FEEBLE-MINDED GROUP 171 

The problem of the primitives has been discussed in 
the chapter on civilization levels. For further illus- 
tration of our argument, the following extract from a 
paper by Charles H. Johnson, Superintendent of the 
Leaks and Watts Orphan House, Yonkers, N. Y., may 
be consulted. He said: 

The slowness of mental development may be due to racial 
causes. In a comparison of white and colored children measured 
by the Binet scale of intelligence, Doctor Josiah Morse, of the 
University of South Carolina, finds that in the same course of 
study and with equally good teachers 29.4 per cent of the colored 
children are more than one year "backward" to 10.2 per cent 
of white children; that 69.8 per cent colored children are "sat- 
isfactory" to 84.4 per cent white, and but .8 per cent of colored 
children are more than one year "advanced" as compared with 
5.3 per cent of white children. However, we are here on de- 
batable ground. The advocates of racial equality will insist 
that such differences are only apparent, and if present are due 
to unequal opportunity. That, given the same opportunity, the 
races will show no inequality. They will say that, while it may 
be true that the brain of the black man is on the average about 
two ounces lighter than that of the Caucasian, yet the variation 
in both races amounts to twenty-five ounces. Also that if the 
brains of the whites and blacks should be jumbled together no 
one could distinguish the one from the other by aid of brain 
weights. Nevertheless, there seems to be an idea prevalent 
among school men that the negro child develops at the Cauca- 
sian rate until the fifth grade is reached, but after that falls 
behind in the competition of intellects. Cornell states that in 
his own experience as a teacher in a medical school handling 
hundreds of medical students, he recalls no negro student who 
was remarkable, and but three or four who were good students. 
The form-board test has been tried on several races and it is 
said considerable differences appeared. As between whites, In- 
dians, Eskimos, Ainus, Filipinos, and Singhalese, the average 
differences were small and much overlapping occurred. As be- 
tween these groups, however, and the Igorot and Negrito from 
the Philippines and a few reputed Pygmies from the Congo, 



172 THE EXCEPTIONAL CHILD 

the average differences were great and the overlapping small. 
If the results of these and other tests could be taken at their 
face value they would indicate differences of intelligence between 
races. One American official in the Philippines complained 
that no natives were mentally over 14 years of age. Another 
stated that the Binet Tests would put it lower. The school cur- 
ricula in the Philippines are graded low, because the Malay can 
only go so far and no further. 

Of course, nobody will dispute the claim that races 
differ intellectually. There have been different grades 
of civilization produced by different kinds of people, 
and there will always be radical differences. But it is 
a very different thing to compare, by using a measuring 
scale, like the Binet, one race with another from the 
point of view of Caucasian civilization. It is certainly 
absurd to draw the conclusion from observations like 
those recorded in the clipping from Superintendent 
Johnson's paper that the " lower" races are on the same 
level with the feeble-minded. And yet, if we would 
take these observations "at their face value" they 
would indicate just that. The -Filipinos, e. g., even 
though they are mentioned in the above clipping in the 
first group of peoples examined, would measure up to 
something like the moron type. And the last sentence 
of the clipping would even doom them to everlasting 
arrest of development at a certain point. 

The author has in his possession an unpublished paper 
written by an American district superintendent of 
schools among the Filipinos. This paper shows plainly 
that these primitive tribes responded well to educa- 
tional influences when they were so directed that they 
attempted to develop a civilization from within, build- 
ing it upon that of the tribe. Failure is apparent as 
soon as attempts are made to force American civiliza- 



THE FEEBLE-MINDED GROUP 173 

tion upon them without careful adjustment. It is per- 
fectly intelligible why all efforts must fail, as they have 
failed in the case of the American negro, and in the 
case of every "white man's burden," to plunge a primi- 
tive people post-haste into the current of an entirely 
new order of civilization and of social effectiveness. 
Civilization is a growth, based upon biological princi- 
ples and upon racial psychology. 

For that matter, the school-books which the depart- 
ment has prepared for the schools in the Philippines 
prove that the Malay pupils have inspired the depart- 
ment with great hopes as to their educability. 

Primitive peoples have much native ingenuity and 
certainly the faculty of growth in their own way. To 
compare them to aments of whatever degree is un- 
scientific. 

Feeble-Minded vs. Lower Strata. — From Superinten- 
dent Johnson's paper this other quotation is taken: 

It is when we reach the higher grades of mental defect and 
approach the dim border-line of normality that our perplexity 
arises. Here are the cases that cause us our educational troub- 
les, those who clog up the grades and finally drop out and are 
lost. These cases cause us our industrial difficulties, filling the 
ranks of the low-paid and unskilled laborers who are in and out 
of a job — mostly out — most of their lives. It is this class that 
creates many of our social problems of crime and delinquency. 
They recruit the ranks of criminals, prostitutes, vagrants, beg- 
gars, and insane. . . . 

And we may add the expression of Doctor Clinton P. 
McCord, Health Director of the Department of Public 
Instruction, Albany, N. Y., who says: 

Personally I feel that the majority of the so-called "environ- 
mental cases" will come to be seen in the near future as products 



174 THE EXCEPTIONAL CHILD 

primarily of bad heredity and absence of prenatal hygiene, 
rather than the results of faulty surroundings. In other words, 
the so-called slum conditions look very much like symptoms of a 
well-defined basic disorder. They have a biologic rather than 
an industrial and social cause. . . . Clean the slums, clothe 
the dwellers there and put money in their pockets, and in a year 
you would return to find the original conditions present. 

The expressions of both investigators are very valu- 
able and touch very sore spots in our social life. They 
agree in substance with what has been said by the 
author on pages 49 and 50. But here again, it must be 
said that it would be erroneous to think that all of these 
cases are cases of mental defect. There are such cases 
among them undoubtedly, and we must admit that 
only a fraction of our really feeble-minded population 
is as yet diagnosed and cared for. But by far the 
greater portion of these "lower strata" is composed of 
individuals and groups which represent, as has been 
shown before, lower civilization levels, primitive ele- 
ments. Some of them never have reached a higher level 
before; others have been brought down from a higher 
level by the "environmental causes" which Doctor 
McCord clearly underestimates. In fact, geographical 
or social isolation — certainly an environmental cause, 
although not in the sense in which Doctor McCord 
uses the term— is the source even of many cases of the 
preservation of the primitive. 

It would also seem as if both quotations treat eco- 
nomic pressure and its causes and effects too lightly. 
They read almost as if they were pleas on behalf of the 
exploiters of the weak, exonerating them of the odium 
which attaches to "frenzied finance," greed, graft, and 
oppression. 



THE FEEBLE-MINDED GROUP 175 

Necessary Distinctions. — We must, therefore, make 
careful distinctions between the feeble-minded and the 
insane (the ament and the dement); the feeble-minded 
and the retarded; the feeble-minded and the dull; the 
feeble-minded and the primitive; the feeble-minded and 
the lower civilization levels. How to make this dis- 
tinction, imperative as it is, is just the problem, and we 
may have to wait for further light on methods of test- 
ing and differentiation before we shall be able to make 
definite statements. 

To recognize an idiot and an imbecile is relatively 
easy. But, as Superintendent Johnson justly says, the 
difficulty begins when we are supposed to diagnose 
lighter cases of mental defect in distinction from lower 
grades of intelligence within the precinct of normality. 
The confusion is greater for the reason that, as Tred- 
gold has shown, aments may possess deceptive excel- 
lencies, while the merely dull may have none of these. 
As a matter of fact, the feeble-minded may learn, or be 
naturally gifted, to do some wonderful things. The 
author has observed the most remarkable skill in lace- 
making, artistic printing, wood carving, etc., among 
distinctly feeble-minded persons. They may excel even 
in certain mental operations, like number work, and 
eventually go with a fair degree of success through 
school grades. It has been claimed by Goddard that 
he discovered feeble-minded pupils even in a certain 
high school — which would indicate, either that his 
standard was faulty or that the school system in which 
this occurred relied on other than real intelligence tests 
for promotion. 

On the other side, the factory methods which prevail 
in present-day production call primarily for a type of 



176 THE EXCEPTIONAL CHILD 

human activity which reduces the human element to a 
minimum and degrades the human worker to the level 
of the machine. Most ordinary tasks of life as at 
present organized call mostly for skill of various degrees. 
In fact there is a great deal of labor, such as digging, 
road work, and similar performances, which are sup- 
posed to be left to the "unskilled" workman, so that 
it would seem not even skill is required for a great deal 
of necessary work. Closer analysis will, it is safe to 
say, show that this "unskilled" labor, while being 
rough labor, nevertheless requires not only skill of a 
definite kind, but even management of the workman's 
own physical resources, of his endurance quality, etc. 
Yet it would seem that among the hosts of those who 
do civilization's rough work, factory work, every-day 
work, the kind of work that reduces itself to almost 
automatic, machine-like movements, intellectual quality 
would not count much; that it can be done by individ- 
duals in which a sharp discrimination between amentia 
and dulness would hardly be necessary. All that is 
needed, it would seem, is a regulation through the orga- 
nized forces of society to keep the elemental energies of 
these groups, which are incapable of self-government, 
within bounds. 

This is the policy which has been characteristic of 
governments of all times. Invariably there have been 
upheavals and revolutions in which often enough these 
very same elemental energies broke forth in destructive 
power. Democratic ideals such as true Americanism 
involves cannot tolerate a policy so utterly at variance 
with the appreciation of individual rights. 

In the chapter which treats of efficiency, on pages 
29 and 31, the problems of democracy in the matter of 



THE FEEBLE-MINDED GROUP 177 

efficiency have been discussed. We may admit that 
aments, or feeble-minded, can have as little recognition 
as independent citizens of a political body as have 
dements, or insane. And it may further be accepted 
that the dull portion of our commonwealth, they who 
can hardly be expected to have a clear perspective of 
the purposes and responsibilities of government, who 
are generally made the tool of unscrupulous politicians 
— "voting cattle," as they are sometimes called, not 
very complimentarily — form a grave problem in the 
regulation of civic rights. 

Yet the two classes are as different from one another 
as day and night. The first class is permanently out- 
side of human society. Its members can thrive only 
under custodial care. They may be trained to do 
many things, and some things well, partly because they 
may be endowed with a special, although mechanical 
talent; partly because they may be trained in skill. 
They will, however, forever remain mechanical, imita- 
tive, incapable of self-direction. They may learn to be 
self-supporting under guardianship, just as a garden will 
pay for itself, or domestic animals will pay for their 
keep, and more. But they are essentially another type 
than the dull or circumscribed intellects, the possessors 
of which have a mind of their own, normal though 
meagre, with a much-contracted mental horizon, under- 
developed but developable, if not in one, then in several 
generations. 

In fact, once being identified by the commonwealth 
as a promising social element, as an asset capable of 
adding ever-increasing increments to the civilization of 
their day, through the development of the efficiency 
factors inherent in their nature, these groups will grad- 



178 THE EXCEPTIONAL CHILD 

ually be relieved from the bondage of factory methods 
and social repression and lifted onto higher planes of 
social service. Invention will be stimulated, so that 
real machinery may take more and more the place of 
the human machines, machinery which will require as 
much efficient service as formerly had to be rendered 
by the independent workman in his individual pursuits 
— machinery of which the linotype, the multiple print- 
ing-press, the locomotive, the automobile, are the proto- 
types. Out of all this will emerge a new civilization, a 
new union of social forces, a system of mutuality, of 
solidarity of interests, of higher ideals of humanity, 
under a form of democratic government the like of 
which history has not yet known. 

With the development of machinery, with the substi- 
tution of mechanical contrivances for human work, 
with the introduction of electricity and other agencies 
of power into our every-day life, so that we shall more 
generally than now cook, and bake, and sweep, and 
wash dishes, and build roads, and dig ditches, and cul- 
tivate farms, etc., by machinery, much of the drudgery 
of the present day will disappear. There may always 
remain some "menial," "unskilled" work to be done, 
and we may need to have drawers of water, hewers of 
wood, and diggers of ditches to some extent. But this 
work can then be done by those who are in the custody 
of the commonwealth: by the feeble-minded group, the 
group that will perform the tasks which require only 
imitation, direction, skill, which can be done by machine- 
like minds, by "domesticated" minds, by minds which 
are not minds at all. 

Methods of Diagnosis. — In medicine methods of 
diagnosis of the various diseases have been developing 



THE FEEBLE-MINDED GROUP 179 

very slowly, even after medical practice had made con- 
siderable headway. To this day physicians differ in 
defining symptoms, and often disagree thoroughly in 
diagnosing an ailment. Where there are conflicting 
symptoms the physician in charge of a patient will 
often invite other physicians to join him in consulta- 
tion for the purpose of correct diagnosis. As a matter 
of fact, there is still a long list of diseases difficult of 
exact diagnosis, regarding which widely different opin- 
ions prevail. 

Medicine is as old as the race. Child study is young. 
Can we wonder, then, that in diagnosing children we 
are apt to grope in the dark when it comes to the dis- 
crimination of conflicting symptoms? Yet, it is very 
necessary to have some standards by which we may 
differentiate between the merely dull and the feeble- 
minded. 

The first caution the author wishes to offer is this: Give 
even an apparently discouraging case the benefit of the 
doubt. Do not put him down abruptly as feeble-minded. 
His response may be disappointing. But this may be 
due to strange surroundings, as in the case of a doctor's 
clinic, or in the inquisition-room at Ellis Island; it may 
be due to timidity; to the manner of the examiner; to his 
way of asking questions, and to a number of other things. 
It requires experience and skill, judgment and charity 
on the part of the examiner to eliminate these disturb- 
ing elements so as to arrive at a fair conclusion. The 
author was present some years ago at the examination 
of a little boy in a well-known psychological clinic, 
when the examiner was ready to put the child down as 
mentally defective. A little questioning revealed the 
fact that the little fellow, who lived in a suburb of the 



180 THE EXCEPTIONAL CHILD 

big city where the clinic is located, had been away from 
home since 8 o'clock in the morning (it was then 4 
o'clock in the afternoon); had been sent from one 
medical clinic to another for physical examination be- 
fore he arrived at the psychological clinic, and had had 
no lunch or rest to speak of. No wonder that his re- 
sponse was slow, sullen, and unsatisfactory. 

The second caution is not to confuse the requirements of 
work with adults and the requirements for testing children. 
Adults have set ways of their own which it is often 
difficult to penetrate. Again, an adult will approach a 
task with a cdrtain worldly-wise suspicion that there 
is a catch somewhere, different from the unsuspecting 
manner of a child who will accept a test on its face 
value. 

Thirdly, even with children, one sitting will rarely 
suffice, except in very outspoken cases. We should 
heed Huey's counsel, who advises against employing 
terms of finality with children, especially young chil- 
dren, where there is the slightest chance of growth. 
Children who are doubtful as to their mental calibre 
should be in observation classes or schools for periods oi 
varying lengths, so that there be opportunity for the 
fullest measure of individual study of the elements of 
growth and development. 

Fourthly, every mental test should be preceded by 
such physical tests as will determine the state of a sub- 
ject's body health and the accuracy of physiologic func- 
tion. The mental tests should be directed mainly to 
ascertain the subject's common sense, and whether his 
mental faculties work in harmony, no matter what their 
range may be. Tredgold's statements as presented on 
page 161 offer a safe basis of judgment. 



THE FEEBLE-MINDED GROUP 181 

Fifthly, let us understand that illiteracy is not nec- 
essarily a danger-sign. Not only with immigrants would 
a literacy test be very misleading, but even with children 
who have attended an American public school. There 
are the elements of opportunity, of poor teaching, of 
sense defects, of defects in the speech centres, as de- 
scribed before. There may be under-development of 
the visual memory. But more fundamental than these 
things is the fact that there are children, representatives 
of the primitive groups, or of the non-literary types, 
who will battle unsuccessfully with reading and writing, 
with spelling and long division all their lives, and yet 
be quite intelligent, very far from being feeble-minded. 
There have been thousands of years of civilization when 
the arts of reading and writing hardly existed at all, or 
were the gift of the few; there are thousands of honest 
and efficient men and women whose eyes will forever 
be puzzled by the printed symbols of spoken words, and 
whose hands will but clumsily and ungrammatically 
write out their thoughts. 

In his work with immigrants suspected of mental 
defect Doctor Howard A. Knox, of the United States 
Public Health Service, Ellis Island, devised several in- 
teresting performance tests which require above all 
things judgment. He described them first in The Jour- 
nal of Heredity, Washington, vol. V, No. 3 (March, 
1914). There is the Cube Test, which will be described 
further in a later chapter; the ''imbecile" test (a kind 
of form board; Knox says that a normal child of 6 can 
fit all the cut-out blocks into their places inside of five 
minutes, with not more than six false moves); the 
"Casuist" Test (another form board, requiring the in- 
telligence of a normal 12 -year-old child); and as the 



182 THE EXCEPTIONAL CHILD 

most difficult test the "feature-profile" test (blocks 
have to be fitted into grooves to complete a human 
face) . 

In the author's own practice, which will be described 
later, much stress is laid upon a combination of tests 
which are intended to ascertain the child's motor con- 
trol and constructive ability; his sense of form and fit- 
ness; his train of ideas and association of thought; his 
power of concentration, discrimination, and logical ex- 
pression; his appreciation of a task, of a situation, of 
the sequence of events, etc. In this wise the funda- 
mental difference between the merely dull and back- 
ward, on the one hand, and the truly mentally defec- 
tive, the ament, can be established with a fair degree 
of certainty. 

Characteristics. — As a further guide to those who 
have difficulty in appreciating this difference, I will 
quote some essential points from Doctor Knox's enu- 
meration of proofs of mental defect, in the sense of 
feeble-mindedness. According to his ideas, these indi- 
viduals possess the following common characteristics: 

i. Inability to make use of such knowledge as they may 
have acquired. 

2. Faulty reasoning and judgment and an inability to cor- 
rectly estimate sizes, shapes, and forms. 

3. Lack of ingenuity and native ability. Defectives are 
usually only capable of performing work that they have already 
learned after painstaking training in much the same way that 
an animal is taught tricks. They are unable to act and to 
think for themselves. 

4. Faulty attention and memory. 

5. Exaggerated egotism. 

6. Selfishness and absence of the altruistic sense. 

7. Emotional instability; ill-timed mirth and grief. 



THE FEEBLE-MINDED GROUP 183 

8. Exaggerated suggestibility, 
o. Inability to withstand temptation. 

10. Early brain fag and absence of the power of sustained 
energy. 

Any one of these characteristics may be discovered 
in people not feeble-minded, through lack of training or 
through special defects. But the clinical picture of 
the ament combines these features in well-defined form. 

Final Criterion. — Those who have carefully read the 
author's definition of efficiency (pp. 18 ff.) and of normal- 
ity (pp. 77 ff.) will appreciate this statement: the real 
difference between the normal and the potentially nor- 
mal, on the one hand, and the feeble-minded, or ament, 
on the other, is determined by the criterion of efficiency. 
In other words: 

A person who has efficiency, no matter how low his per- 
formance level or how limited his skill, is actually or po- 
tentially normal — perhaps dull, but never feeble-minded. 

Inefficiency marks a person as an ament, no matter how 
much skill he may be trained to develop, or how high his 
performance level may be in terms of skill only. 

'"Common sense" is only another term for efficiency, 
mentally speaking. The other elements of human effi- 
ciency have been enumerated in their proper place. 

The Prayer of the Defective Child 

william franklin rosenblum 

O Lord, I come to Thee as the Supreme Comforter. I am 
called the defective child. The sons and daughters of men turn 
from me. They look at me in pity and in scorn. My father 
thrusts me from him. My mother weeps over me and mutters: 
"These are the wages of ignorance and sin." The teacher says 
I am "backward" and hopeless. My classmates call me "fool." 



184 THE EXCEPTIONAL CHILD 

O Lord, what have I done? Tell me, Thou who art all- wise 
and all-merciful. What have I done? Do not turn from me, 

God. Give me love. Oh, how I hunger for love. For the 
strong embrace of a father, for the soothing caress of a mother. 
And how I yearn for playmates, yet none will play with me. 

Is it a sin to be a defective child ? Turn not from me, O Lord, 

1 am innocent — innocent — innocent. 

From the Survey, Sept. 25, 191 5. 



CHAPTER X 

JUVENILE DELINQUENCY 

What Is Crime ? — Does crime consist only in doing 
what is forbidden by law? There is many a thief who 
steals by legal methods. There is many a murderer of 
soul and body who destroys without calling forth the 
operation of the law. Said W. R. Hearst, in an edi- 
torial published soon after the drowning of over one 
thousand people in the Eastland disaster in Chicago in 
July, 1915: 

The safest kind of murder is wholesale murder. If you kill 
one man you are hanged. If you kill a thousand you go free. 
If you kill a hundred thousand you are a hero. 

The Slocum disaster killed 1,700 people to make a few extra 
dollars. One little subordinate was condemned to jail and soon 
freed. 

The Titanic raced through the ice to please the vanity of one 
man. Fifteen hundred were killed. No one was punished. 

People by the thousands are burned in unsafe buildings, 
drowned through carelessness and greed and no responsible per- 
son is ever reached. . . . 

On the other hand, there is many a person caught in 
the net of the law who is in reality a perfectly honor- 
able man or woman. There are legal offenses which 
are not moral offenses. Law is very surprising in many 
of its workings, showing the limitations of the human 
mind in codifying rules of conduct. In a certain dis- 
trict in Ireland a man who had stolen a pig was put 

185 



186 THE EXCEPTIONAL CHILD 

in jail for three years; in the same court, a man guilty 
of manslaughter received a sentence of only one year. 
In the State of New Jersey a young lad was recently 
put in prison for one year for killing a rabbit (which 
was against the game-laws) ; the same court sent a man 
who had brutally maltreated his wife to jail for three 
months. Examples of this kind of "justice" can be 
multiplied. 

Law is a convention for the convenience of what is 
considered an ordered community life. It is largely a 
matter of force, just as government is a matter of force. 
The time has not yet come when reason and psychologic 
insight will govern nations. 

Sometimes the valuation of a man's deed depends 
upon his success. Was Napoleon (Case 54) a criminal 
or a hero ? Was George Washington (Case 55) a traitor 
or a patriot? Points of view differ in the matter of 
judging historical personages, and one who is dear to 
millions may be denounced by other millions. The 
present war is full of such divergences of estimation. 

Again, the valuation of a man's character and his 
social standing may depend upon local standards and 
opportunities. America is full of derelicts from Euro- 
pean countries who were "shoved off" by their relatives 
and sent across the sea to escape disgrace and legal 
prosecution in their fatherland. Some of these went 
under. Many, however, learned their lesson in the 
hard school of life, or found their opportunity to make 
good and to show what stuff they were really made of. 
It was, at one time, proverbial that it was never safe to 
ask a Texas gentleman or an Australian settler about 
his past; he might answer you with a bullet from his 
revolver. But these men with a shrouded past made 



JUVENILE DELINQUENCY 187 

a new civilization. Add to these the many escaped 
convicts who had been banished to a penal colony in 
the Pacific and succeeded in starting life anew in some 
far-away settlement, and you have a variety of exam- 
ples illustrating the strange relation between law and 
crime. 

The Veneer of Civilization. — Our civilization is as 
yet a very superficial thing. "The veneer," said an 
editorial writer some years ago in Current Literature 
Magazine, "which has after many centuries been spread 
over our primitive and barbaric instincts, is very thin, 
even at the best; and it frequently takes but a genera- 
tion or so of ignorance, poverty, and isolation to wear 
it away to the vanishing-point." 

It is well that we should make it very clear to our 
own minds that our modern sensitiveness to crime is 
really a very new thing. What we now, at least theo- 
retically, condemn as criminal has been common prac- 
tice in past centuries, at least under certain conditions, 
but quite generally, and much of what we call crime is 
nothing but a continuation of these practices and a 
recrudescence of primitive instincts and modes of action. 

Let us remind ourselves of a few of these things. 

Man's Inherent Savagery. — Arthur McDonald, in 
"War and Criminal Anthropology," 1 says: 

According to geology and prehistoric anthropology, man was 
a savage hundreds of thousands of years. The world has been 
civilized only five or six thousand years, and civilization is nec- 
essarily on the surface of human nature. . . . Civilization, 
though its foundation be comparatively shallow, can, neverthe- 
less, suppress or cover up man's deep-seated savagery, causing 
it to remain dormant. 

1 Pacific Medical Journal, April, 19 15. 



188 THE EXCEPTIONAL CHILD 

Dormant, yes, but not dead. 

The handling of offenders, whether they were offend- 
ers against the social order, or against liberty, or against 
despotism, has never been characterized by anything 
but cruelty. Let us be reminded of the horrible cus- 
tom of torture; of the studied cruelty in putting men 
to death by impaling them alive on stakes, or crucify- 
ing them, or burning them alive. Even hanging by the 
neck, the killing in an electric chair, or the execution 
by shooting to death cannot claim for themselves much 
"humanity." Our modern prisons are better than the 
dark, underground dungeons of old, with their lack of 
air and comfort, with their filth and vermin. But the 
modern prison is a very recent thing, indeed. Besides, 
in other parts of the world, conditions still exist which 
defy description. 1 And we 'must not forget that our 
mode of life has changed, and to one who is accustomed 
to even modest comfort of the modern kind the very 

1 Under the caption, "Most Terrible Punishment in the World," Popu- 
lar Mechanics for December, 1914, has this report: "Political offenders 
in parts of Mongolia are punished by lifetime immolation in coffin-like 
boxes stored away in dark dungeons. These boxes are only large enough 
to contain a man. There is but one aperture, and that no larger than 
the head. His hands are manacled, and twice a day attendants bring 
food and drink, which are placed in the shackled hands outstretched 
through these round windows, which are his only communication with 
the world. Many highly educated Chinese, so it is said, are imprisoned 
here. Within the cramped box one cannot sit upright or lie flat, and a 
gleam of daylight is seen only when the door swings open to admit the 
attendants bearing food." The magazine illustrates this information 
with pictures showing some of these horrible, filthy prison-boxes in a 
dungeon in Urga, in northern Mongolia. 

In Persia to-day the most cruel punishments are in vogue. Perfora- 
tion of the nose, cutting off of one or both ears, chopping off the hand, 
are quite common. Torture is still employed for the purpose of forc- 
ing a suspect to confess a crime which he possibly did not commit. One 
form of this torture consists in placing red-hot coals on the top of the 



JUVENILE DELINQUENCY 189 

best of our modern prison-cells is a terrible thing. Be- 
sides, not many are "best." The story of our American 
prison has not yet been fully told. 1 Imprisonment even 
in a civilized dungeon for years or life is barbaric. Our 
dealings with the criminal are still very unenlightened. 
Can we forget the lynchings, the "law of the plains," 
the "unwritten law," the "third degree"? 

War and the Primitive. — The still-prevailing custom 
of duelling to avenge a gentleman's "honor" has its 
counterpart in the nation-wide duels, or wars. At the 
present time, when the greatest war of all history is 
being waged between the most civilized of modern na- 
tions — employing methods of mutual destruction which 
are the product of the most advanced forms of scientific 
research and mechanical skill as well as of the most 
fiendish impulse of maiming and killing — who can say 
that we have advanced very far beyond the primitive 
instincts such as would characterize a "criminal"? 

head, which has previously been carefully shorn of all hair. Capital 
punishment is inflicted as a public spectacle, with all kinds of slow 
methods of causing extreme pain before death finally relieves the un- 
happy victim of Oriental "justice." 

And what about the political prisoners in the Siberian mines ? About 
the French prisoners' colonies on Devil's Island, etc. ? 

Must we be reminded of the Terrible Three in Venice ? Of the Inqui- 
sition ? 

1 Those who read Jack London's " Star Rover "will doubt whether we 
have reached a very high level in prison methods in these modern days. 
Morrell, quoted on page 6, who went into a California prison soon after 
his twenty-first birthday under a life-sentence, spent five years of his 
term in a dungeon. As an inmate he has seen, as he reports, the "bull- 
ring," the " chloride-of-lime cell," the "tricing-up irons," and other 
forms of torture formerly inflicted on many convicts in prisons through- 
out the country. At the end of sixteen years he was pardoned. At 
his home in Philadelphia (South Fifty-sixth Street) he is now organiz- 
ing "The Honor Men's League," with volunteers from prisons for mili- 
tary service. 



190 THE EXCEPTIONAL CHILD 

The lust of battle is in man's heart now as ever it was 
in the breast of the brute caveman who slew his neigh- 
bor with his rude weapons of stone, and with clubs 
broken from the branches of trees. The "God of Bat- 
tles" is implored by either side to give the victory. 
This "God of Battles" is nothing but the "God of 
Commerce," that is the God of Selfishness who impels 
nations to drive the competing nations from the mar- 
kets of the world, by means fair or foul. Brute force 
and cunning are still the reigning endowments that 
decide success. 

Says Professor G. T. W. Patrick, of the University 
of Iowa, in an article, "The Psychology of War," in the 
Popular Science Monthly, August, 191 5: 

The student of psychology will ... see that the history of 
mankind for thousands of years has been a history of incessant 
warfare and that the new economic and industrial conditions 
which have made war irrational are not more than about one 
hundred years old, while the human brain is practically the same 
old brain of our fathers and forefathers, deeply stamped with 
ancestral traits and primitive instincts, which cannot thus sud- 
denly be outgrown. It is society which has suddenly changed, 
not the units of society. . . . 

The high tension of the modern workaday life must be peri- 
odically relieved by a return to primitive forms of behavior, as 
in football, baseball, hunting, fishing, horse-racing, the circus, 
the arena, the cock-fight, the prize-fight, and the countless forms 
of outing. Man must once again use his arms, his legs, his larger 
muscles, his lower brain centres. He must live again in the 
open, by the camp-fire, by the stream, in the forest. He must 
kill something, be it fish or bird or deer, as his ancestors did in 
times remote. . . . Periodically, however, man seems to need 
a deeper plunge into the primeval and this is war. 

What he says tallies with the previous quotation from 
McDonald. Perhaps no other people in the world are 



JUVENILE DELINQUENCY 191 

so close to such recrudescences of primitive instincts as 
are the Americans. In fact, quite apart from our de- 
sire to shake the dust of civilized life from our feet and 
to seek the wilderness for recreation in camp life, we 
have been beginning civilization over again with every 
new State that has been added to the Union. The 
ranchers and trappers of the "wild West"; the mining 
prospectors in the ore-bearing mountains; the dwellers 
in the camp towns at the fringe of civilized life, where 
the beginnings of settlements are made — have their 
own laws. The reckless self-assertion of the desperado 
who makes the "tenderfoot" dance to the music of the 
bullets from his revolver, is a favorite theme of our 
novel-writers. 

Reverberations of Primitive Instincts. — Quite apart 
from these more brutal forms of primordial recrudes- 
cences, are we so far away from mediaeval and primitive 
methods of life and conceptions of right and wrong? 
Are our habits of cleanliness so far advanced that we 
do not allow any filthy tenements and unsanitary back 
alleys? Is our respect for the other fellow's property 
so great that we disregard opportunities for appropriat- 
ing it when they present themselves to us? The old 
story of the fellow who steals a loaf of bread being put 
in jail while the grafter who steals a million is elected 
into the common council is still true in some cases. 
Our business ethics are dominated over by business 
greed, and it is sometimes seriously discussed whether a 
business man, in order to sell his goods with profit, can 
really always tell the truth. What must we think of 
the swearing off of taxes ? Of the influence of corpora- 
tions upon the making of laws? Of the cruel exploita- 
tion of children so that we must have a National Child 



192 THE EXCEPTIONAL CHILD 

Labor Committee? Where is our social conscience? 
Is the kind of conscience which we claim really char- 
acteristic of our well-advertised modern civilization? 

The fascination which bright things have upon primi- 
tive man, and the elemental instinct for pilfering and 
stealing, manifest themselves daily in the conduct of 
many people. One of these manifestations appears in 
the souvenir craze. Hotel men recognize the wide- 
spread nature of this craze so fully that they are accus- 
tomed to put down against profit and loss the disap- 
pearance of thousands and millions of spoons, napkins, 
china, and other things which the "collecting instinct" 
of guests, especially women, have prompted them to 
take away in their travels. 

The old instinct of trusting to chance, which was per- 
fectly normal with the hunting nomad, is coming up 
constantly in our games of chance, in our gambling and 
betting habits, and in the proceedings of the stock ex- 
change. The author knows personally perfectly nor- 
mal and splendid men and women who will now and 
then be caught in the fever of stock-gambling, in mar- 
gins and futures, often ruining themselves and their 
families without realizing that they have done so be- 
cause they have allowed a primitive instinct to over- 
power their modern social conscience. They have 
fallen back on the lower brain centres — the higher asso- 
ciations taking a vacation, as it were. 

Racial Elements. — In previous chapters reference has 
been made repeatedly to the differences in mental and 
moral attitude due to racial causes, and to differences 
among the civilization levels in modern society. The 
various races of the world, with their various historical 
experiences, have developed very different codes of 



JUVENILE DELINQUENCY 193 

ethics and very different mental processes. The tortu- 
ous mental methods of the Orientals, with their singular 
insincerity and subtle cruelty, are well appreciated by 
those who know the Asiatic mind. The "Black Hand," 
the "Mafia," the Chinese "Societies," and similar or- 
ganizations testify to the peculiarities of racial types 
foreign to the average American. At the death of the 
former Mikado of Japan an illustrious Japanese general 
and his wife committed "harikari," that is, suicide by 
disembowelling, in honor of the departed — a procedure 
so horrible that our Western mind cannot grasp its 
possibility. In the mixture of races in a common- 
wealth like the American these racial differences must 
be taken into account as seriously as must be the other 
conditions which allow recrudescences of the primordial. 

Juvenile Offenders, — All this preliminary argument 
was for the purpose of giving the right background and 
perspective to the problem of juvenile "delinquency." 
This problem has been looming up with increasing force 
in late years, and through the establishment of chil- 
dren's and juvenile courts, and of research departments 
connected with them, in some places, it has been studied 
from various angles. 

The foregoing may convince some of us that we 
should treat this problem with caution. 

Delinquency and Feeble-Mindedness. — Much stress 
has been laid by some upon the effect of feeble-minded - 
ness as a potent cause of juvenile crime. There is no 
doubt that a certain class of mentally abnormal children 
is potentially or actually criminal. But the author is 
inclined to put the percentage of this class of criminals 
low. It is interesting to note how even those who be- 
lieve in imbecility as an important factor in crime speak 



194 THE EXCEPTIONAL CHILD 

more particularly of a certain class of imbeciles— the 
"moral imbecile," the "imbecile with criminal in- 
stincts," and the like. Doctor Walter E. Fernald de- 
scribes imbeciles with criminal instincts, saying that 
"while in mere memory exercises they may excel, they 
have weak will-power. The power of judgment is de- 
fective and uncertain, and often determined by chance 
ideas, not by the outcome of past experience. Thought 
is scanty, limited mainly to daily experiences. They 
are unable to grasp and utilize the experiences of life." 
He has never known an imbecile to exhibit traits of 
remorse. Correction or punishment is of little effect. 
He continues: "Every imbecile, especially the high- 
grade imbecile, is a potential criminal needing only the 
proper environment and opportunity for the develop- 
ment and expression of his criminal tendencies." He 
suggests that cases of imbecility with criminal propen- 
sities can be recognized at an early age, before they have 
acquired facility in crime, and should be permanently 
taken out of the community. 

Similarly Doctor Krapelin describes his conception of 
"moral imbeciles" as follows: "Their lack of sympathy 
is manifested from youth up in their cruelty toward 
animals, their tendency to tease and roughly use play- 
mates, being unable to yield to moral influences. They 
develop the most profound selfishness, a lack of the 
sense of honor, and of affection for parents and rela- 
tives. It is impossible to train them because of the 
absence of love and ambition in their constitution. 
They tell falsehoods, are crafty, deceitful, stubborn. 
Their egotism becomes more and more evident in their 
great conceit, their bragging and wilfulness, their in- 
ordinate desire for enjoyment, their violence and dissi- 



JUVENILE DELINQUENCY 195 

pation. They are incapable of resisting temptation and 
give way to sudden impulses and emotional outbursts, 
while the susceptibility to alcohol is especially promi- 
nent." 

Doctor Healy, in his book on "The Individual De- 
linquent," publishes facts which should be carefully 
compared with the statements made by the investiga- 
tors quoted. He writes: 

The group of individuals properly designated under modern 
nomenclature as idiots rarely, if ever, are criminals. In prac- 
tically all cases they are found so intolerable socially on account 
of their mental defect that they are early segregated and pro- 
tected. The middle grade of feeble-minded, namely, imbeciles, 
are more frequently encountered in connection with court work, 
but are not at all numerous. We ourselves have seen less than 
a dozen cases among 1,000 young repeated offenders, but readily 
concede that in certain institutions where older chronic misde- 
meanants are sent a larger proportion might be found. It cer- 
tainly is rare that imbeciles become major offenders. This is 
because they are very often readily perceived to be socially un- 
desirable, and while young are sent to institutions for the feeble- 
minded. 

The fact which Healy's investigations point out as 
most important is this that "as we go up in the scale of 
mentality we naturally find more ability to be an active 
delinquent." 

That the percentage of feeble-minded among our 
youthful delinquents is much smaller than some inves- 
tigators used to think is being proved by later researches. 
Of the 1,276 children who were arraigned during the 
year 1913 in the children's court of Buffalo, only 53 
were found to be retarded in mental development (a 
little over 4 per cent). Of these 53 only 8, or about 
two-thirds of 1 per cent of the total, could be pronounced 



196 THE EXCEPTIONAL CHILD 

distinctly feeble-minded, using the Binet scale. In the 
Seattle Juvenile Court, in 191 2, careful examination re- 
vealed ouly 6.4 per cent of the delinquents to be feeble- 
minded, the majority of them so-called "border-land" 
cases. A study which Miss Augusta Bronner made on 
500 delinquent adolescents is published in the Journal 
of Criminal Law and Criminology of November, 1914. 
In her examination she used first the ordinary school 
methods to test the scholastic standing of the subjects. 
Those who were deficient in these subjects were tested 
with the Binet scale. This is her conclusion: "On the 
basis of a study of more than 500 cases in a group as 
little selected as is possible to obtain, we find the per- 
centage of feeble-minded to be less than 10 per cent, 
while the group of those normal in ability exceeds 90 
per cent." Had Miss Bronner employed a more flexi- 
ble scale she would probably have found the percentage 
of feeble-minded still smaller. 

Even if, in some larger centres of population, the per- 
centage should be found to be greater, the methods of 
testing would have as much to do with this result as the 
local conditions of congestion, economic pressure, etc., 
and no sweeping generalization is justified. 

The feeble-minded delinquent, as Healy showed, is 
apt to be a minor offender, not only because imbeciles 
are early recognized and segregated, as he says, but also 
because they are as a rule incapable of comprehensive 
planning. The low-grade delinquent who would pre- 
sent real danger is the one who has preserved some 
special abilities which are not counterbalanced and con- 
trolled by other intellectual elements, or by sane moral 
motives. There are also those who have defects in 
special mental abilities which throw the normal func- 



JUVENILE DELINQUENCY 197 

tioning of the mind out of gear. Healy enumerates 
language defects, defects in arithmetical ability, in judg- 
ment and foresight, and in self-control. It is plain that 
these individuals are by no means necessarily feeble- 
minded. 

The really dangerous and successful criminal is usually 
a person of good intellectual endowments whose career has 
been warped by an early derailment of some kind. 

" Psychopathic Personalities." — Professor Thomas H. 
Haines, of the Bureau of Juvenile Research, Columbus, 
Ohio, writes: 

There are cases of delinquency in which experts will agree that 
there is deficiency of the moral or social organization, while no 
definite defect in intelligence can be made out. There is defect 
in the organization of the self and in the power of self-control. 
This defect is inherent, also, and cannot be remedied by educa- 
tion. This class of cases some are classifying with defective de- 
linquents. They are close to what have been called psycho- 
pathic personalities and cases of moral insanity. The defect is, 
of course, more difficult to define than a definite intelligence de- 
fect. It is also less certain that it is congenital and non-recover- 
able. For these reasons attempts to refor/n, through most skil- 
fully guided education, should be made. This is the class for 
our reform schools. No clear defectives should be sent thither. 

If we compare this statement with those of Fernald 
and Krapelin, we may be inclined to think that even 
the cases the latter investigators had in mind are really 
of the psychopathic kind. Unfortunately, Professor 
Haines's statement contains a self-contradiction. If 
"the defect is inherent, and cannot be remedied by ed- 
ucation," it is difficult to see how it can be "recover- 
able" through skilfully guided education in reform 
schools. 



198 THE EXCEPTIONAL CHILD 

Referring to Chapter VIII, on "Psychopathic Dis- 
orders and Psychopathic Constitutions," the author 
wishes to state it as his opinion that indeed many 
youthful delinquents are the victims of neurasthenic 
conditions. Neurasthenia implies lack of nerve poise 
and a generally unstable nervous condition. There are 
subliminal upheavals which bring instincts and impulses 
to the surface without restraint, which in the child of 
proper nerve poise are held under the control of his 
inhibitive power. Hysteria is not uncommon among 
children, and is the source of many manifestations of 
this kind. The development of puberty and ado- 
lescence often leads to crises in the lives of children 
when the awakening sex instinct plays havoc with the 
direction of the will. Masturbation, excessive sexual 
imagination, and all those phenomena which Professor 
Freud describes in his theory of dreams in their relation 
to early sex manifestations, must all be considered in 
studying the causes of juvenile delinquency. 1 It is a 
well-known fact that incendiaries (pyromaniacs) are al- 
most always of adolescent age, so that the tendency to 
set fire to things seems to be an expression of a perverted 
sex instinct. Generally speaking, all criminals begin 
their criminal career in the adolescent age. It is thus 
demonstrated that this period in a child's life is beset 
with dangers requiring the most careful educational 
attention. Again, it is often the exceptionally bright 
child, especially the type suffering from psychopathic 
tension (the fourth group as described in Chapter VII) 
that may develop, through misdirection of its poten- 
tials, success in criminal activity. Leaders may be- 

l Cf. following chapter, also p. 151, "Sexual Neurasthenia." 



JUVENILE DELINQUENCY 199 

come misleaders, excellence may be perverted into the 
extreme of criminal cleverness and success. 

Epilepsy and Crime. — The tendency of epileptics to 
do sly and underhand things, to strike and injure, and 
eventually to do all kinds of acts which in the sense of 
the law are criminal is well known to those who have 
studied this strange affection. There are few reforma- 
tories which have not some padded cells for epileptic 
inmates. It has become a well-established practice in 
some places to segregate epileptics in colonies and vil- 
lages where they are under proper medical and educa- 
tional supervision. We may look for the enactment of 
laws which will make such commitment compulsory 
without attaching a stigma to the patient. Of course, it 
will be well to be careful in discrimination, as there have 
been persons of distinction and fame in history who 
were sufferers from this treacherous disease. Even in 
these cases we may find that their career was influenced 
by the antisocial, self- aggrandizing and even cruel ten- 
dencies so characteristic of this affliction. Possibly the 
greatness of Napoleon I (Case 54) would not have been 
tainted by such astounding neglect of the value of 
human lives had he not been an epileptic. Of the trial 
of the Camorrists in Italy mention has been made in a 
previous chapter. 

Medical Relief. — These neuropathic conditions call 
imperatively for the co-operation of the physician in 
juvenile-court cases. In the matter of pubescent and 
adolescent perversion, we may have to look not only 
for psychopathic conditions as such, but for local irri- 
tations. Even prepubertal irritation has caused havoc. 
Sex abnormalities in the male and female child, such 
as lead to rape and prostitution, have often a back- 



200 THE EXCEPTIONAL CHILD 

ground of neurotic constitution. But there are many 
minor physical conditions which require attention. 
Physicians attached to juvenile courts have testified to 
the fact that medical and surgical treatment and relief 
have cured many a "criminal." In the appendix of 
this book contributions from medical experts will eluci- 
date these facts further. 

Primitive Types. — The author has shown in various 
places in this book how much of the tension which leads 
to antisocial explosions he ascribes to the preservation 
or reassertion of primitive instincts. If even the adult, 
as has been shown in the opening paragraphs of this 
chapter, is subject to these recrudescences of primeval 
tendencies, the child, who is much closer to the aborigi- 
nal mental level, must be admitted to be in still greater 
danger, under the stress of emotional impulses, especially 
in the period of adolescence. The valuation of chil- 
dren's acts should be made on the basis of a full knowl- 
edge and realization of the facts set forth in the begin- 
ning of this chapter, and we should never forget to ask 
ourselves, in judging of offenders, be they old or young, 
"What is crime?" Let us also be aware of the fact 
that moral standards differ with peoples and with his- 
torical periods. The attitude of the Greeks toward the 
sex problem, for instance, was very contrary to the 
Oriental attitude, and both entirely different from mod- 
ern conceptions. In certain tribes among the Eskimos 
it is the filial duty of thte eldest son to put his old father 
to death as soon as the old man is unable to earn his 
own livelihood; for these tribes have no chance of lay- 
ing up stores for the non- workers, and it is a tribal 
necessity to remove the disabled. In many peasant dis- 
tricts of the Old World the old people are obliged, by 



JUVENILE DELINQUENCY 201 

the force of tradition and custom, as soon as they reach 
a certain age, to relinquish their property, their farm, 
to the oldest son and to retire to a little outhouse (the 
"Ausgedinge"), where they live under stipulated condi- 
tions, but depending much upon the good will of their 
successor in management. Different social strata have 
often totally different codes of ethics and moral concep- 
tions, and hardly understand each other's ideas on 
moral obligations, just as in some Old World countries 
the inhabitants of neighboring villages fail to under- 
stand each other's speech, speaking different dialects. 
All these things are reflected in the conduct of our chil- 
dren, and may bring them into conflict with established 
law and order. 

Undoubtedly there are individuals who have ferocious 
and fiendish instincts — the instincts of the destroyer. 
They are cold and without emotion — the life of a man 
or his sufferings mean as little to them as the life or 
sufferings of a beetle mean to the "naughty" boy who 
pulls out his legs. Here we are again dealing 1 with 
relics of barbarism, with types of arrested development, 
in which the primitive instincts still have full sway. 
Each boy passes through such a period naturally, but 
during childhood days these instincts rarely lead to 
terrible results. They are lopped off in the course of 
mental and physical growth in the child of normal de- 
velopment, under the right environmental and educa- 
tional influences, with sufficient outdoor and play exer- 
cise. Yet stories are told of perfectly normal children, 
by no means criminals, who acted in a most cruel man- 
ner, entirely without self-consciousness, purely in the 
naivete and primeval unconcern of childhood. 
X C/. p. 174. 



202 THE EXCEPTIONAL CHILD 

Economic Conditions. — Poverty, economic pressure, 
underfeeding, overwork, lack of play and recreation — 
of the opportunity to dwell peacefully in that paradise 
of childhood which is the birthright of every boy and 
girl — maltreatment, misunderstanding, bad companions, 
and the other thousand and one causes of waywardness 
lead more children along the path which ends at the 
children's court than any other single cause. Many 
children are habitually hungry and always tired. They 
lead a slave life before school in the morning and after 
school in the evening, with scanty meals, much scolding 
and buffeting, stuffy sleeping-rooms, filth and disorder 
around them. Many have no home at all. The author 
knew of a girl (Case 56), bright, refined, and artistic in 
taste, ambitious, whom he had occasion to rescue from 
the police prison in San Francisco; she had been, with 
her eighteen years, in fourteen different "charitable" or 
State institutions, being a homeless waif. One midnight 
in New York he saw on the steps of an elevated station 
a little chap of perhaps five years (Case 57), fast asleep, 
dirty, with a bundle of papers tucked under his arms. 
The tragedies of child life have not been fully told. 
The cruelty exerted upon the innocents by parents, 
relatives, employers, exploiters, is hardly understood by 
the average humane man or woman. Of the subtle 
sufferings of children in well-to-do homes where there 
is no spirit of sympathy with real child life nothing need 
be said here. 

Many a home of the poorer classes, where otherwise 
there would be love and care, is poisoned by economic 
helplessness. Says John D. Barry, in the Los Angeles 
Express of March 22, 191 5: 

As a result of a single visitation of sickness many a family 
finds itself overwhelmingly in debt. The paying of this debt 



JUVENILE DELINQUENCY 203 

may take years. During this time the debt may hang over the 
family like a cloud. And where it does not hang over the family 
like a cloud it may result in another kind of demoralization, 
creating the spirit of graft, of advantage-seeking, of weak ac- 
ceptance of charity and, finally, the expectation of charity. So, 
often, the degeneracy of a family may be traced to one sickness. 
As a result of the sickness the members of the family often find 
that they cannot meet their debts. They feel a deep sens"e of 
injustice. Moreover, a few months after the sickness has dis- 
appeared it becomes unreal. To pay for that disagreeable ex- 
perience gradually begins to seem unnecessary. So they forget 
to pay. Incidentally they learn how easy it is to impose on 
others, to escape meeting their obligations. For there is nothing 
in the world more easy to acquire than the spirit of graft, which 
is in its nature either dishonesty or the preparation for dis- 
honesty. 

Again, when it comes to the saving of those juvenile 
offenders who, for small sins of commission or omission, 
have landed in the children's court, and who are so lit- 
tle culpable that it would be an injustice to send them 
to jail, another difficulty arises. Mary R. Fulgate and 
C. A. Mitchell, of the Social Service Department of the 
Boys' Court of Chicago, compiled a report submitted by 
Judge Dolan to Chief Justice Olson a few years ago. 
This report contains the following significant facts: 

Idleness is at the root of most of the mischief, and this is par- 
ticularly true of the boy brought up among sordid surround- 
ings. . . . 

The problem of finding work for the boys has been one of the 
most difficult. It is easy to get money for the work of the de- 
partment, but when it comes to a job for the boy willing and 
anxious to work it is different. Hundreds of letters have been 
sent out by this department to the large employers of labor ask- 
ing for work, but less than 5 per cent have responded. 

This, the investigators say, is because boys who have 
been taken to court on any charge whatsoever are con- 



204 THE EXCEPTIONAL CHILD 

sidered "lazy, incompetent, and perhaps criminally in- 
clined. Instead, the majority are honest and capable, 
and enforced idleness is the prime cause of their delin- 
quency. Unemployment is responsible, indirectly, for 
at least 70 per cent of the offenses charged to boys in 
this court." Another most instructive statement is 
made by these investigators which runs counter to the 
conceptions of many, namely, that habitual indulgence 
in liquor is negligible and chronic alcoholism is practi- 
cally unknown. "Of 10,000 cases heard by the court 
not more than 50 had their inception in minds de- 
ranged by liquor." On the other hand, cigarette-smok- 
ing is so frequent and pronounced that it has "assumed 
almost the form of a mania." 

An Interesting Bit of Statistics. — Bearing out these 
various contentions, Doctor Lillian Merrill's findings in 
the Seattle Juvenile Court show the following causes 
of delinquency in the cases studied in 191 2: 

Fifty-two per cent were due to social and economic conditions. 

Twenty-nine and five-tenths per cent to physical pathology, 
including neurotic heredity, sex pathology (including phimosis), 
adenoids, and enlarged tonsils, malnutrition, cardiopathic condi- 
tions, sensory defects, etc. 

Eighteen and five-tenths per cent to mental pathology, includ- 
ing moral deficiency, backwardness, epilepsy, and at the end of 
the line — feeble-mindedness. 

The Problem of Truancy. — The reader may remem- 
ber the mention made of a report on truancy on page 
68. It claims that of all the 150 cases studied 43 per 
cent were actually feeble-minded, and 8 per cent were 
border-line cases. The author objected at that place 
to the obviously one-sided method of classification 
used in that study. In contrast to the report's esti- 



JUVENILE DELINQUENCY 205 

mate is the result of an investigation of ioo typical 
cases of truancy undertaken by James S. Hiatt, Secre- 
tary of the Public Education Association of Philadel- 
phia, and published 191 5 by the United States Bureau 
of Education. Mr. Hiatt found only 6 per cent men- 
tally deficient, against 26 per cent backward and 68 per 
cent normal. He claims that the real cause of chronic 
truancy is difficult to ascertain. In any case it is prob- 
ably a complex of causes, no one of which seems para- 
mount. Some of the contributing causes he found to be : 

Bad companions 20 per cent 

Fault of home 29 per cent 

Dislike of school 26 per cent 

Desire to work 10 per cent 

Illness 4 per cent 

Fault of boy 11 per cent 

In a number of cases, he says, there seems to be no 
definite cause except that the child is a " misfit" in the 
school system. The reader is referred to the initial 
chapters of this book for an explanation of this really 
paramount cause. 

For too many active boys, representing types to 
which dry book-lore and memory tasks mean little, the 
ordinary school is a veritable prison-house. Mr. Hiatt 
finds 26 per cent to have become truants from dislike of 
school; the 10 per cent who desired to work may be 
put down, at least in part, to the same motive; this 
means about one-third of the entire number. Similar 
conditions may be expected to prevail in most places. 
Even when the boys do not play truant they will urge 
their parents to take them out of school before finish- 
ing it. Among them are the over-age pupils, those that 



206 THE EXCEPTIONAL CHILD 

fail of promotion — because their individual needs are 
not recognized. It is a significant fact that many of 
them when placed in a truant school are much better 
satisfied if that school offers outlets for their real needs, 
as in manual training, outdoor work, gardening, con- 
structive work of all kinds. This is parallel to the well- 
known observation that gang-rule and gang-viciousness 
are at once checked as soon as public playgrounds and 
boys' clubs are established in the congested tenement 
districts which usually harbor juvenile gangs. As soon 
as the real boy is appealed to, there is little or no tru- 
ancy or viciousness. 

To those who believe unduly in the gospel of the 
three R's, Whittier's beautiful poem on "The Barefoot 
Boy" should be quoted over and over again: 1 

"Knowledge never learnt of schools — 
Of the wild bee's morning chase, 
Of the wild flower's time and place, 
Flight of fowl and habitude 
Of the tenants of the wood; 
How the tortoise bears his shell, 
How the woodchuck digs his cell; 
And the ground-mole sinks his well; 
How the robin feeds her young, 
How the oriole's nest is hung; 
Where the whitest lilies blow, 
Where the freshest berries grow, 
Where the ground-nut trails its vine, 
Where the wood-grape's clusters shine; 
Of the black wasp's cunning way — 
Mason of his walls of clay — 
And the architectural plans 
Of gray hornet artisans ! 

1 Cf. also the author's "Some Fundamental Verities in Education," 
PP- *9Jf- 



JUVENILE DELINQUENCY 207 

For, eschewing books and tasks, 
Nature answers all he asks; 
Hand in hand with her he walks, 
Face to face with her he talks, 
Part and parcel of her joy — 
Blessings on the barefoot boy ! " 

The two critical ages, when this "Wanderlust" wells 
up in the normal boy, are from eight to ten years, and 
at the time of adolescence — both being periods of change 
and readjustment in the physiological function. 1 

That certain classes of defectives are prone to yield 
to nomadic instincts cannot be denied. This instinct, 
in some cases, appears as a reverberation of primitive 
modes of life. The "Wandertrieb" or "Wanderlust" 
is also characteristic of some psychopathic conditions, 
such as manifest morbid fears and restlessness, or hyper- 
stimulation of the imagination, or epileptic symptoms. 
That nomadic promptings also follow attacks of weak- 
ening diseases when the desire to work regularly is 
markedly at low ebb, is known to every physician. 

Children's Lies. — The chapter of children's lies and 
deceptions is a long one, and one which alone would 
give much food for thought. A child who lies is not 
necessarily wicked on that account. Even perfectly 
normal children may lie because they misunderstand a 
situation; because they are not yet able to distinguish 
between pictures and reality, or between imagined, or 
dreamed, happenings and their actual experiences. 
Often they believe in their own imagined adventures. 
As the wish is father to the thought, children sometimes 

1 Cf. "The Career of the Child," pp. 96/.; p. 275; and Chapter XIX, 
" Criminality in Children." 



208 THE EXCEPTIONAL CHILD 

state as facts what they had simply hoped would occur. 
Again there is the powerful dramatic instinct of chil- 
dren and their impulse to act and pose. They wish to 
produce an effect so as to test their own powers, to ex- 
periment upon their elders. Often it is merely their 
play instinct, a "make-believe" frolic which induces 
them to "tell tales"; the wise educator will accept these 
in the spirit in which they are told. There are a hun- 
dred and one perfectly normal conditions under which 
a child will tell what is contemptuously called a lie, and 
it requires skill and tact on the part of the educator to 
handle such cases. The child's motive must be under- 
stood. 

Further, there are causes for lying for which parents 
and educators are almost alone to blame. We make 
our children tell untruths and practise deceptions for 
the sake of our own convenience, at the home — when 
unwelcome visitors come, or in the practice of social 
pretense — and in many other ways, and then blame 
them for using the same method against us. Then 
there is the fear of punishment or misunderstanding. 
As a matter of fact, this fear in thousands of cases be- 
comes so deep-rooted in a child's soul that it causes life- 
long unhappiness, or marks the beginning of a life of 
deception, of resentment, and of antisocial tendencies. 

Lies are also the result of physical causes, temporary 
or chronic. Indigestion, fatigue, nervous exhaustion, 
and other conditions of this kind, will produce a con- 
fusion in the child's mental activity and lead to the 
making of misstatements. 

This argument is not intended to veil the fact that 
there are constitutional liars. Lying is a symptom of 
certain psychopathic and "degenerative" conditions 



JUVENILE DELINQUENCY 209 

when the normal personality dissolves. It is common 
with the epileptic degenerate and with the " moral im- 
becile." There are children who cannot tell the truth, 
even if they "wanted to." This tendency has nothing 
whatever to do, in many cases, with intellectual defects. 
Again, there are otherwise perfectly normal individuals 
who go through life as successful and pleasant men and 
women, who have the weakness of prevaricating, of fib- 
bing, of telling stories — and whom no bitter experience 
will cure of this disorder. The author knows of a 
lovable man of great ability who is more than naive in 
the matter of truthfulness and is rarely aware that he 
is telling inventions of his own; who even escaped pun- 
ishment for an actual forgery only because of his win- 
ning ways and the fact that he had acted "in good 
faith," which was recognized by those who had cause 
to feel aggrieved by his action. 

Misconceptions of Normal Conditions. — The misun- 
derstanding of perfectly normal children is responsible 
for many a derailment in a child's life. If educators 
will learn to appreciate the order in which instincts and 
impulses awaken in a child in successive periods; if they 
will study the budding times of different manifesta- 
tions; if they will realize that a child is not merely a 
small man or woman whose standards of conduct must 
meet those of his elders, but a being different from the 
adult, passing through mental stages of development, 
they will judge differently. 

The honored judge of the children's court in one of 
our large cities told the author in confidence that when 
he was a boy he lived in the toughest part of the town, 
was a member of the toughest gang of boys, himself 
the toughest boy of the gang, and every "cop" was 



210 THE EXCEPTIONAL CHILD 

afraid of him. It is for this reason that he is now such 
a splendid judge of boys. The director of compulsory 
education in the same city, after twenty years of ser- 
vice, told the author: "Some of the brightest and best 
young men of this town were the worst scamps I had 
to deal with when they were boys, and I do not believe 
it is fair to them to hold their records up against them. 
I wouldn't give a snap of my finger for a boy that is 
not chuck-full of life and getting into mischief about all 
the time." 

What, pray, is the difference between the boy who 
helps himself to his mother's jam from the family cup- 
board or uses his mother's Chinese vase as a target for 
his marble practice, and the boy who, after stealing an 
apple from the grocer's open barrel, or smashing a street 
lamp, is hauled before the juvenile court? Both are 
following their primeval instincts. The difference is 
that the former is a boy taken care of in a good home, 
and that the other must be satisfied with the street for 
his playground. 

Education plays, of course, a great part in all these 
things — the right education — and many a sin is com- 
mitted from ignorance and thoughtlessness, from lack 
of wise guidance. 

Weak Wills and Unsocial Instincts. — Undoubtedly 
we have children with weak wills who will be influenced 
by bad companions, by bad examples, by a generally 
bad environment. A weak will is not necessarily a 
vicious will, nor is it necessarily an evidence of feeble- 
mindedness. In these cases we must study the social 
causes with great care. An ounce of prevention is 
worth a pound of cure, and social reform will do away 
with many of the temptations and possibilities of crime. 



JUVENILE DELINQUENCY 211 

Special care should be taken to give children of this type 
the right direction in the matter of sport and amuse- 
ment. Moving pictures can be made to be of great edu- 
cative value — the ordinary kind which appeals to the 
sensational is a bad incentive for the undiscriminating 
child. Weak wills can be strengthened. And if the 
rotten apple is removed from the barrel it will not 
cause the others to rot. 

Bad habits and loose principles are acquired when 
there is no incentive for, and no knowledge of, the oppo- 
site. From whatever side we approach this problem 
we find it to be largely an educational one. 

Unsocial instincts are often the result of lack of op- 
portunity for social endeavor, or of lack of training of 
the social instincts. There are many boys who have 
never been socialized, living in a sordid and disorganized 
environment in which chance and passion alone reign 
supreme. Again, there are persons, even children, of 
so pronounced an individuality that it is difficult for 
them to fit themselves easily into grooves and conven- 
tions. They hate restraint, they hate conventionality 
and rise against all obstacles that stand in the way of 
their self-assertion. These must not be confused with 
the self-centred psychopaths. They are powerful egos, 
full of life and vigor and initiative. Real or imagined 
grievances will be resented by them, and they will 
assert their rights, or what they think are their rights, 
to the bitter end. Our social conscience is, after all, 
the product of most recent developments. It was not 
so long ago when individual honor was supposed to 
stand much higher than social honor; when individual 
self-protection came before the protection of the body 
social. It is a matter of individualism versus society. 



212 THE EXCEPTIONAL CHILD 

A few centuries ago such a man would have been strictly 
within his legal rights, at least within the limits of the 
social conscience. The "unwritten law" prevails to 
this day, and many an avenger of his or her honor has 
been acquitted by a jury. Duels, "feuds," and "ven- 
dettas" are not altogether a thing of the past. 

There is a new individualism dawning, which is not 
antisocial, or asocial, but in which society will find its 
consummation. 

Conclusion. — Juvenile delinquency is caused by many 
different things. It touches upon the problems of men- 
tal and moral defect, of psychopathic conditions, en- 
vironmental influences, educational organization, etc. 

In treating the juvenile offender, the truant, the "in- 
corrigible," the boy or girl who is hauled before the 
juvenile court, one must see at once that a thorough 
knowledge of conditions is required before judgment can 
be passed. These conditions are physical, psychologi- 
cal, environmental, racial. In a relatively small num- 
ber of cases we shall find such depravity or abnormality 
that the decision must lead to permanent segregation 
and custodial care. We need a new type of officers of 
the law — experts of child life and child nature. Instead 
of the ordinary reformatories and penal institutions we 
should have educational and psychological clinics, medi- 
cal dispensaries, home schools, forest and farm schools, 
occupational schools, and children's sanatoria for those 
children who are in danger of derailment. 

The establishment of children's courts, of attendance 
officers, probation officers, and the method of placing 
children away from their own environment into good 
homes, have been only the first steps in the right direc- 
tion. 



CHAPTER XI 
SEXUAL PERVERSION AND PROSTITUTION 

Prostitution and Feeble-Mindedness. — It has been 
claimed that a very large percentage of our sexual per- 
verts and prostitutes belongs to the feeble-minded class. 
Closer investigation has shown that this is not the case. 
There is, of course, a percentage of feeble-minded among 
this group of unfortunates, just as there is among the 
criminals and delinquents, dependants and destitutes. 
The same causes — lack of proper stimuli, of ability to 
plan, of forethought, of self-discipline, etc. — which pro- 
duces the other types of human derelicts, act in this 
case. But the percentage of mentally defective prosti- 
tutes is as small as that of feeble-minded criminals. 

Surely, there are silly girls, giddy girls, fond of amuse- 
ment and dress; there are girls who are "common," 
coarse, vulgar, whose habits of conduct lack self-respect 
and the control of the higher sentiments — who therefore 
will indulge in the vulgar in sex matters as they do in 
other things. But the very words "common" and 
"vulgar" indicate that they represent a type which was 
once common, and that it is only our refined conscience 
of the twentieth century which rebels against their kind. 

There are voluptuous girls and girls in which the 
sexual instinct is more than normally developed, either 
on account of a physical abnormality in the sex-organs 
or in the secondary sexual areas; or through genuine, 

213 



214 THE EXCEPTIONAL CHILD 

general precocity, physical, functional, emotional, and 
mental. 

Even the silliest girl, however, is not an ament, while 
the precocious boy or girl may be in danger of true 
psychosis, even dementia. In both instances we are 
dealing with conditions which can be greatly influenced 
by environment, training, education, and remedial mea- 
sures of various sorts, including medical. 

The Tragedy of Woman's Life. — A young girl, fun- 
loving, attracted to the other sex b|y the natural instinct 
of the period she is living through, is running a much 
greater hazard than the male youth of the same period. 
The young man is usually care-free, and can go on living 
his own life without encumbrance. But the girl, if moth- 
erhood should follow her indiscretion, is at once an out- 
cast, and her fate is beset with many dangers and cares. 
She is often driven to a life of shame. Law, order, and 
the social conscience are slowly preparing to meet these 
emergencies in the spirit of charity and humane under- 
standing. Foundling asylums do not solve the prob- 
lem. The nearest society has ever come to an apprecia- 
tion of the conditions involved, is in the care of the so- 
called war-babies, the birth of which has brought the 
significance of the problem closer to the individual con- 
sciousness. 

Puritan self-consciousness and self-righteousness alone 
cannot relieve the situation, and is not a standard of 
normality as such. 

It is only just to refer, in passing, to the fact that re- 
spectable society is honeycombed by similar flaws, and 
that it does not behoove us to cry out against the mote 
in our neighbor's eye when the beam in our own is so 
much in evidence. 



SEXUAL PERVERSION AND PROSTITUTION 215 

Ignorance and Prudishness. — As all sexual perverts, 
prostitutes, and moral derelicts of the sexual type have 
once been pupils of our schools, and certainly children 
in our homes, it behooves us to study the sexual life of 
our children and to consider the conditions which may 
lead to derailment. 

We may safely say that almost all cases of sexual per- 
version might be regulated if we could get hold of them 
at the time of incipiency. But only very few parents 
and teachers know anything at all of the awakening of 
the sex instinct in their children and pupils; many of 
them even shun the discussion of this topic as unclean 
and improper when it is, in reality, perhaps the most 
vital factor of all education. Neither our habits of liv- 
ing and regulating our lives in general, nor our tradi- 
tional ways of handling our children take this great 
factor of life into consideration. 

We allow our children to grow up in ignorance of the 
character and importance of the sexual function and 
of the hygiene and ethics of the sexual life. Deception 
on the part of the parents, however, invariably brings 
about deception on the part of the child. 

There are enormous differences in regard to the time 
when a child matures sexually. Some are erotically de- 
veloped at five or six, others not before twenty. The 
erotic always finds opportunity to inform and excite 
himself, be it from observing the chickens or even the 
flies, or from playing with other children and with ser- 
vants. The cold-blooded individual, on the other hand, 
derives no excitement even from the most detailed 
sexual explanation. 

The lies parents tell about their origin, the avoidance 
of the topic of human procreation, of the meaning of 



216 THE EXCEPTIONAL CHILD 

marriage and parenthood, the prudishness displayed by 
morbid minds in the matter of nude art — do not make 
the children better. On the contrary, this practice 
makes them curious and suspicious, self-conscious, and 
secretive; and after discovering the truth, or what they 
think is the truth, they have lost respect for their parents, 
who were ashamed of telling them of the very thing that 
had made them their parents. Thus the sanctity of 
the marital and parental relation is at once destroyed 
in their consciousness, and the children become accus- 
tomed to look upon the sexual life as unclean and 
obscene. 

Sexual Education vs. Sexual Hygiene. — Sexual educa- 
tion, however, is not identical with the teaching of 
sexual hygiene. Important as the latter is in a way, it 
can never take the place of the former, while sexual 
education may eventually be effective without any sci- 
entific knowledge of the hygienic part. 

Sexual education is in part a matter of training a 
child in habits of cleanliness, of physical and mental 
self-control, of self-respect and self-improvement. It 
depends upon proper physical training so that the body 
may be strong, vigorous, and enduring, capable of with- 
standing physical and emotional strain. "Mens sana 
in corpore sano." It depends upon the cultivation of 
the habit of truthfulness and exactitude. Truthfulness 
in the prompt and unvarnished statements of question 
and answer in matters where the child wants informa- 
tion, help, and guidance. Truth told by the parent to 
the child who must have the confidence that he will 
always have the true answers from his parents to his 
searching questions as to the origin of things, the origin 
of his own being. In this manner the parents will fore- 



SEXUAL PERVERSION AND PROSTITUTION 217 

stall the evil thoughts and practices created by un- 
satisfied curiosity, by erotic imagination, by the 
obscene suggestions from his companions or from 
menials. 

Truth, yes. But not necessarily the whole truth at 
once. There are stages of intellectual growth in the child 
to which the answers can be adjusted. And the truth is 
not merely a physiological truth; there is a spiritual truth. 
The sexual life of man is bound up with the highest 
emotions and ambitions; with the instinct and passion 
of love with all its wonderful tenderness; with the in- 
stinct of the reproduction of the self, of a new realization 
of the self, of a spiritual no less than a bodily reincarna- 
tion. The sexual instinct has been the basis of the 
earliest mythologies and religions: creation, the polarity 
of the male and the female element in creation, and the 
mystery of procreation, have inspired the religious think- 
ers of all times and have given color even to the most 
spiritual of all religions which recognizes the "father- 
hood of God." 

As there are stages in the spiritual growth of the 
child, so there are stages in the development of his, or her, 
sex life. These must be carefully watched. The com- 
ing on of puberty is fraught with much danger because 
a profound revolution takes place in body and soul at 
this time. Now, much intelligent, loving, and tender 
guidance is needed, so that the "new birth" be one for 
sanity, purity, and constructiveness. Adolescence is the 
period of much derailment. Crime and prostitution 
have their recruiting stations at this age. The mere 
teaching of sex hygiene will not prevent derailment 
through passion; mere knowledge is not virtue; fear of 
consequences is not a safe guide. 



218 THE EXCEPTIONAL CHILD 

Home and Its Influences. — Sexual education is a 
complex problem. But its basis is a true and sweet 
home life; the building up of right ideals of living, of a 
strong and pure character in the children; of right rela- 
tions between parent and child; infusing the spiritual 
element into education. Children who respect and 
honor their parents, having learned from their lips the 
secret of life, the great divine wonder of procreation, 
will never look upon the passion of love as an unclean 
thing, or upon their own origin as an obscene act of 
which their parents must be ashamed or which justifies 
the young in following the promptings of lust and 
voluptuousness. 

Marital Choice. — Faulty conceptions of the marital 
relation in the average home have been responsible for 
much of sexual tension and unhappiness, with conse- 
quent violations of the sacred vow. It is not even now 
the practice of parents in all cases to let their children 
do the choosing of their mates. In their fear that the 
young might choose unwisely — mostly from the point 
of view of station and wealth, ever so philistinely con- 
ceived — many parents insist upon selecting their chil- 
dren's life partners. The ancient custom of the Orientals 
of selling the bride to the highest bidder is not alto- 
gether a thing of the past, and girls are carefully trained 
to be attractive so that they may bring their price in 
the market. Princesses marry for "political" reasons 
and have rarely a love-life of their own. The state of 
mind in which a girl is when she surrenders herself to 
her marital purchaser cannot differ essentially from 
that of the prostitute who sells her body outright. 
This morally unhealthy condition has not been condu- 
cive to fostering a sane and pure sexual attitude. 



SEXUAL PERVERSION AND PROSTITUTION 219 

Promiscuous Relations of Children. — Again, the un- 
regulated relations of children in our homes (often 
enough rather nomadic in character), in the streets and 
tenement-houses; their kissing games; their early court- 
ships, often of an outspokenly erotic character; the 
way in which the young lady of the house receives her 
young man, with the studied exclusion of the family 
and of parental influence, are examples of the other ex- 
treme, which leads to license instead of freedom, to 
temptation instead of fortified experience. 

Tenement Conditions. — In the crowded homes of the 
tenements the human derelicts are deprived of that 
amount of privacy which modern ideas of a clean life 
require. Those of us who know the unspeakably naive 
conceptions and practices which prevail in southern 
countries of Europe in regard to public "comfort sta- 
tions" — who know that these things exist openly, even 
in such civilized countries as Italy and Spain, not to 
speak of our own southern neighbors — will be charitable 
in their opinions of the shamelessness and filth existing 
in our "slum" districts. Nevertheless, it cannot be 
denied that the close cohabitation of old and young, 
breeding lack of modesty and privacy, and conducive to 
reckless exposure and filth, will stunt the sensibilities 
of the young and lead to loose ideas and habits of per- 
sonal morality. Unclean habits and shamelessness nur- 
ture prostitution and crime. 

Morbid Sexuality. — The development of the sexual 
impulse should be watched with solicitude. Through 
local or neurotic irritation, or through maladjustment 
of the growth factors, a distinct sensuality may be 
caused, with sexual precocity, a premature awakening 
of the sexual impulse in both boys and girls. Often the 



220 THE EXCEPTIONAL CHILD 

body is not strong enough to resist the onslaught of 
these powerful instincts in their budding time, when 
they are rushing forth with elemental force, and are 
least understood by the child; more often the will is not 
ethically developed for successful inhibition of unhealthy 
promptings, and the nervous system is still too unset- 
tled to withstand the strain. 1 The result is a general 
havoc and shipwreck. In adolescent girls disturbance 
in the menstrual rhythm produces irritations and ex- 
citations leading to moral and nervous breakdown. 
This is the typical period of masturbation, although mas- 
turbating tendencies have been observed in very young 
children. 

The effect of masturbation on the system has often 
been overestimated and parents have been needlessly 
frightened. Nevertheless, we must be watchful and 
cautious, as prolonged or excessive indulgence in this 
habit is distinctly harmful to the functional and mental 
life of the individual. 

Masturbation is often caused by those sedentary hab- 
its promoted by our present methods of classroom in- 
struction with books. The nervous wriggling of a child 
in his seat, especially when the seat is not properly ad- 
justed, is very often a danger-signal. 

Masturbation is not always a sexual act in the sense 
that the masturbator thinks of the opposite sex. There 
are cases of inversion when the sexual impulse is abnor- 
mally directed toward the masturbator's own sex. The 
act is often merely the gratification of a local irritation, 
as in the condition mentioned in the preceding para- 
graph; or it is the result of a desire to get rid of an un- 

1 Cf. Hall's remarks, quoted on p. 137. Also "Sexual Neurasthenia," 
p. 151. 



SEXUAL PERVERSION AND PROSTITUTION 221 

pleasant and exciting sensation. Anxieties, fears, ex- 
pectations of pleasurable or unpleasurable kind, may 
lead to the setting free of the masturbating impulse or 
even to an excitation of a true sexual impulse. This 
sexual impulse cannot be gratified in the normal way 
by sexual intercourse in immature children, or even in 
adolescents of the domesticated and "moral" type, and 
therefore leads to artificial gratification, which means 
onanism or masturbation. It has been established be- 
yond doubt that the overwhelming majority of boys 
masturbate at some time or another, in many cases 
keeping up the practice through life, even after marriage, 
in preference to intercourse with prostitutes. The per- 
centage of masturbating girls seems to be smaller, al- 
though it is difficult to obtain absolute figures. Girls, 
however, masturbate more frequently and often with 
greater intensity than boys. 

Early Intercourse. — -The sexual impulse, when not 
normally gratified, may have grave pathological effects 
in the physical as well as in the psychical sphere. Early 
marriages should therefore be considered with favor, at 
least in respect to those whose sexual life awakens early 
and is strong in passion. Many children of sexual pre- 
cocity are tempted to gratify their promptings by early 
intercourse. It has been established in the Chicago 
Domestic Relations Court by very careful investigations 
into the causes of prostitution that a surprisingly large 
percentage of girls had their first "fall" in the home of 
their parents. 1 We may be reminded that in certain 

1 " You can imagine my astonishment when on compiling my social 
statistics for the last six months of the first year's work, I discovered 
that the girl's own home, under her father's own roof, was three times as 
great as any other factor. Out of a total of 225 cases listed this place 
was 63; out-of-doors, 21; assignation houses, 16; man's home, 19; place of 



222 THE EXCEPTIONAL CHILD 

peasant districts in Europe it is almost a legitimate 
privilege of the lover to visit his sweetheart nights in 
her own chamber. The sexual relations are not always 
and everywhere carefully circumscribed but more or 
less in the open and promiscuous. What has been said 
in the beginning of this chapter about "common" and 
"vulgar" practices may well be remembered here. 
Those who know the intimate history of the royal courts 
of the Middle Ages are aware of the fact that in those 
"highest circles" the relations between knights and 
ladies were anything but platonic; our modern standards 
represent almost a different civilization. 

Ancient Sex- Worship. — Here we touch upon another 
element which deserves attention in our endeavor to 
understand and handle this difficult problem. The 
problem of prostitution, and for that matter also that 
of inebriety, which is often co-ordinated with the mani- 
festations of the sexual instinct, must be, at least in 
part, considered in the light of manifestations of primi- 
tive instincts and aboriginal mental attitudes. Sex- 
worship and revelry formed important elements in 
ancient religions. The sacrifice of virginity was as 
much a religious act as offering one's self-control at the 
altar of Bacchus. 1 Prostitution was an act of service 

girl's employment, 9; place of man's employment, 6, etc., etc., demon- 
strating another fact that these girls' falls were due in some measure to 
acts of omission on the part of parents: neglect, criminal neglect." — 
From a paper by Judge Goodnow. 

1 Intoxication, according to Doctor G. E. Partridge, was originally an 
accompaniment and the source of those exalted psychical states neces- 
sary for the development of individual and racial consciousness, which 
meant enlarged mental horizon and the lifting of individuals and nations 
to levels of constructive mental activity. In time the race acquired the 
fixation of these levels, and the intoxication impulse had served its use- 
fulness. 

"The impulse survives to-day in its harmful aspects," says the New 



SEXUAL PERVERSION AND PROSTITUTION 223 

in the temples of Astarte and Venus. We are dealing, 
in a measure, in our modern problems, with reverbera- 
tions of primordial conceptions and impulses. Mod- 
esty, in the modern sense, did not exist in those times 
and peoples. It is, of course, very difficult to project 
our modern consciousness, our modern ideas of right 
and wrong,, of virtue and vice, onto the level of these 
primitive instincts and mental attitudes. There is 
hardly a bridge leading from one to the other. Yet, in 
judging of individuals, we must bear in mind the ex- 
perience and evolution of the race. Chapter III on 
"Different Civilization Levels in Modern Society" gives 
further enlightenment on this subject. 

Racial Differences and Their Modern Counterparts. — 
An example of how moral conceptions differ racially, or 
in different civilization levels, is contained in Miss Blas- 
coer's report on colored children in New York (quoted 
before). She writes: 

York Medical Journal in reviewing Doctor Partridge's book, "Studies in 
the Psychology of Intemperance," and continues: "It no longer has a 
great function to perform. It dominates individuals and social groups 
when they are unable to reach these higher levels of activity, to direct 
their vital energies into these channels, and so are dependent upon its 
temporary and inefficient exhilaration. They find in it also a social 
reaction, likewise inadequate and evanescent, but a feeble survival of 
the effective social awakening that intoxication produced in the early 
history of mankind. The narcosis of alcohol or other drugs is now 
merely a refuge for those whose mental organization demands release 
from the too great pressure which they are unable to meet in the ceaseless 
struggle for existence and advance, the unequal struggle between in- 
stinctive forces and ethical conditions." This is true to some extent, 
but there are other factors entering into a discussion of this prob- 
lem. 

According to Doctor Partridge, the cure for habitual intoxication must 
consist in directing the activities of the sufferer to higher spheres, which 
must be such as are capable of arousing an interest sufficient to stimulate 
and sustain him in his best endeavor. 



224 THE EXCEPTIONAL CHILD 

(Case 58.) A curious family arrangement was found in the 
case of one of the children in the exceptional group. A boy, E. 
S., 9 years 9 months old, in the 4B grade, was kept out of school 
because he had no shoes. On visiting the home address given in 
the school it was found that he and his sister were being given their 
meals there by their father's wife, but slept in the home of their 
mother, who was never married and who had had two other chil- 
dren by other fathers. The father was in the West, employed in a 
large hotel, and had sent no money for the maintenance of the 
boy and his sister for six weeks. Mrs. S. was very ill, with what 
proved later to be pernicious anaemia, and could not earn enough 
money to care for the children. After much persuasion she 
permitted the matter to be placed in the hands of the Charity 
Organization Society, whose efforts brought a substantial re- 
sponse from the husband. She refused, however, to permit 
application to be made for the commitment of the children. 
She was a refined, intelligent woman, a West Indian of French 
descent, and said she wished the children to be in their mother's 
custody if she herself was no longer well enough to care for 
them. When asked whether she thought it was doing justice 
to the children to have them brought up by a woman of loose 
morals, she said: "I should not regard Miss H. (their mother) 
as a woman of loose morals. She is and always has been a very 
hard-working young woman, and if I make myself content with 
these arrangements, I cannot see why the public should feel 
concerned. 



Examples of this kind can be multiplied by those who 
know the situation. But we should be far from correct 
if we were to persuade ourselves to think that concep- 
tions like these are confined to "lower" races or civiliza- 
tion levels. The author knows of another case where a 
" curious" crosswise arrangement was carried out quite 
in legal form. The parents of a certain boy (Case 59) 
had obtained a divorce and each one had remarried. 
The father, Mr. A., married Mrs. B., the divorced wife 
of his friend, Mr. B., who in turn married Mrs. A., the 



SEXUAL PERVERSION AND PROSTITUTION 225 

divorced wife of the boy's father. Mr. A. kept his boy 
to live with him and his new wife, the former Mrs. B., 
who kept her little daughter from her former marriage 
with her. Mr. A.'s little daughter, the boy's sister, 
stayed with his and her mother, the new Mrs. B. and 
former Mrs. A. The children visited the new homes of 
their respective mothers or fathers at stated intervals, 
and the families remained friendly with one another. 
New children were born to either couple, thus compli- 
cating the family relations. Similar occurrences are 
recorded in the journals of the courts of all cities. Every- 
thing is perfectly legal and the charge of "loose morals" 
as made against the poor colored woman, cannot even 
be breathed against these wealthy and highly refined peo- 
ple, who feel that they are perfectly within their rights. 

Malpractice with Children. — Even in the case of early 
malpractice with children, parallels with primeval con- 
ceptions may be drawn. In his book, "Das Geschlechts- 
leben in der Volkerpsychologie " ("The Sexual Life in 
Folk Psychology"), Leipzig, 1908, page 557, Otto Stoll 
reports cases from uncivilized countries; and to his ac- 
count of the defloration of children he adds this state- 
ment: "From all such details we draw the ethnologically 
remarkable inference that those human beings who 
have attained the highest level of civilization relapse 
frequently, in the matter of sexual life, into the rudest 
instincts of savagery; and that in this respect neither 
does one civilized country much excel another, nor is 
'civilized man' in a position to cast many reproaches 
in the teeth of the savage." (Quoted by Moll.) 

Malpractice on children is of course one of the most 
potent causes of eventual prostitution, as it awakens 
the sexual instinct prematurely and destroys the safe- 



226 THE EXCEPTIONAL CHILD 

guard of the sense of shame, at the same time disorgan- 
izing the psychic life of the child among many other 
lines of volitional and ideistic elements. How serious 
this matter is may be gauged from the fact that deflora- 
tion has taken place in girls as young as nine or ten 
years. There have been mothers of eleven and twelve 
years. If these matters are brought into court more 
damage is often done by having the children present in 
open court during the time testimony is given, thus ex- 
posing them to the relation of immoral details. 

As Moll says in his very instructive book, "The Sex- 
ual Life of the Child," page 231: 

The mental condition of the child-depraver is a matter of the 
utmost importance. In cases in which we find that the offender 
is suffering from some pronounced mental disorder, such as 
progressive paralysis (paralysis dementia), senile dementia, or 
an epileptic disturbance of consciousness, there can be no doubt 
as to the existence of irresponsibility; but it must never be for- 
gotten that in the early course of such diseases these sexual per- 
versions often make their appearance at a time when no other 
definite signs of the brain disease have as yet appeared, and 
that for this reason the conviction of innocent persons — old men, 
for instance — on account of sexual offenses against children 
often occurs. Kirn, who in the Freiburg prison had under ob- 
servation six old men at ages from 68 to 81, all convicted for 
sexual offenses against little girls, states that in all of these there 
were intellectual defects, and in several of them pronounced 
symptoms of senile dementia. The psychiatric expert must 
examine all such cases with the utmost care. We may also ex- 
press a wish that judges were not inclined to regard themselves 
as experts in this field, of which, as a rule, they have no expert 
knowledge whatever. 

This last caution is well put in regard to many cases 
of sexual perversity and prostitution, even of crime and 
delinquency in general. 



SEXUAL PERVERSION AND PROSTITUTION 227 

Causes and Remedies. — Abraham Flexner, in his 
study of "Prostitution in Europe," published under the 
auspices of the Bureau of Social Hygiene, by the Cen- 
tury Company, New York, says: 

In so far as prostitution is the outcome of ignorance, laws 
and police are powerless; only knowledge will aid. In so far as 
prostitution is the outcome of mental or moral defect, laws and 
police are powerless; only the intelligent guardianship of the 
State will avail. In so far as prostitution is the outcome of 
natural impulses denied a legitimate expression, only a rational- 
ized social life will really forestall it. In so far as prostitution 
is due to alcohol, to illegitimacy, to broken homes, to bad homes, 
to low wages, to wretched industrial conditions — to any or all 
of the particular phenomena respecting which the modern con- 
science is becoming sensitive — only a transformation wrought by 
education, religion, science, sanitation, enlightened and far- 
reaching statesmanship, can effect a cure. 

Illegitimate Offspring. — In a letter to the author, 
B. S. Steadwell, president of the World's Purity Fed- 
eration, made the following interesting statement: 

Of course, very few prostitutes have any offspring. The 
mothers of most children born out of wedlock are not prostitutes 
by any means; they are in the main unfortunate and betrayed 
girls. The fathers of such children are largely libertines, to be 
sure, but even this hereditary influence is not sufficient to "doom 
them to perdition." I have had an opportunity to study many 
of these children during the past eighteen years, and I have been 
much surprised to find them in the main evenly balanced and 
healthy, beyond the average child born in the home. We have 
found, too, that these young mothers have had an easier time 
during confinement than the average wife. 

These statements are most instructive. They show 
that the protection of law and custom is not as strong 
as it might have been thought to be. Physiologically 



228 THE EXCEPTIONAL CHILD 

speaking, the illegitimate mother and the illegitimate 
child are superior to those who have the sanction of 
church and state. This is a curious, perhaps disquiet- 
ing example of the supremacy of the natural, God-given 
instinct as compared with man-made standards. For 
these mothers, and in many instances the fathers, too, 
yielded to the primordial instinct of love, without think- 
ing of the opinion of the "world," of conventional 
standards, and of organized society. This is, perhaps, 
unfortunate, and certainly has its drawbacks. Besides, 
it would be a wrong conclusion to deduct from these 
facts a justification of what has been called "free love." 
But it does signify that man has hedged himself in un- 
duly with conventions — has fettered himself as if in 
fear of his own legitimate and natural promptings. 
These social chains, partly forged under economic pres- 
sure, have weakened his physiological constitution to 
some extent. It will be well to consider the necessity 
of re-establishing a more natural basis for marital rela- 
tions than has obtained for a long time under modern 
conditions of life. 

Conclusion.— It is obvious that an unguarded sexual 
life may lead a child, boy or girl, to failure in school 
and home. The child may suffer from nervous break- 
down, from backwardness, from "incorrigibility," and 
eventually land in the reform school, the "street," the 
jail. The problem of sexual health is, therefore, one 
which gravely concerns educators and which should be 
considered in all its aspects and in all efforts to improve 
educational conditions through clinical research. 

But we must be clear in our minds about this: the 
problem we have discussed in this chapter is one that 
cannot be solved by milk-and-water methods; by allow- 



SEXUAL PERVERSION AND PROSTITUTION 229 

ing prejudices and prudishness to dictate our measures; 
by letting emasculated men and good old ladies who 
have passed the critical age formulate ascetic rules of 
conduct. It is a problem of warm-bloodedness, of 
virility, of deep-rooted legitimate instincts — instincts 
which guarantee the power and permanency of human 
civilization. It cannot be solved by denying love and 
procreation their full right of self-assertion, by insisting 
on puritanical doctrines of the mortification of the flesh, 
by hysterical tirades about ''white slavery" and by 
crusades against the "social evil." It requires a sane 
and scientific appreciation of facts ; a calm and conserva- 
tive study of conditions; and a sympathetic and humane 
attitude toward those unfortunates who are now treated 
as outcasts and who are, most of them, merely human. 



PART II 

THE PROBLEM OF CLINICAL RESEARCH 
AND DIAGNOSIS 

CHAPTER XII 

THE DETERMINATION OF EXCEPTIONAL DEVELOPMENT 
IN CHILDREN 

Different Methods of Testing. — How different meth- 
ods of testing will affect the findings, especially when 
there is obscurity in terminology, may be shown by 
many instances. This cause alone has been responsible 
for the many erroneous ideas about the percentage of 
feeble-mindedness and mental defect in the common- 
wealth; about the danger that our race may be degen- 
erating; about eugenics and marriage and a host of 
other things. To illustrate: 

Some investigators have placed the number of dis- 
tinctly feeble-minded persons as amounting to 2 and 
more per cent of the entire population; while other in- 
vestigators, in other places, using different scales of 
measurement, have found considerably smaller percent- 
ages. In Raleigh, S. C, the number of feeble-minded 
children was estimated as 28 out of 3,800, or about 
0.7 per cent. In England and Wales the proportion of 
feeble-minded to the normal is 1 to 248, or about 0.4 
per cent. On Ellis Island, where the medical examiners 
introduced some interesting methods of rapid testing of 

230 



EXCEPTIONAL DEVELOPMENT IN CHILDREN 231 

immigrants suspected of mental defect, it has been 
shown that not more than 0.2 per cent can be called 
feeble-minded. In the July number (191 7) of Mental 
Hygiene, Edith M. Furbush, statistician for the National 
Committee for Mental Hygiene, gives figures which are 
equally reassuring. The census of January, 19 17, shows 
a total of 37,220 feeble-minded persons in institutions 
throughout the country. The epileptics enumerated, 
which now come under the mentally defective class, 
totalled 10,801. In 1910 the Federal Census Bureau 
estimated that not over one-tenth of the feeble-minded 
were being cared for in institutions. On the same basis, 
the article says, and assuming that increase in feeble- 
minded has been at the same rate as the general popula- 
tion, there is now about one-sixth of the total feeble- 
minded population in institutions. This would mean 
that there are 223,320 feeble-minded people in the 
United States. If the total population of the country is 
estimated as something above one hundred millions, Miss 
Furbush's figures would mean that the percentage of 
feeble-minded is as low as one-fifth of 1 per cent — a 
peculiar coincidence with the Ellis Island figures. 

Hereditary and Congenital Data. — In any system of 
tests that is to give reliable data, the causes of mental 
exceptionality must be discovered as far as possible. 
The greatest difficulty will be encountered in the study 
of hereditary and congenital causes, including venereal 
infection. Family data are not easily obtained. The 
heredity charts made up in some places endeavoring to 
trace the members of certain families through genera- 
tions and centuries, are of doubtful value, inasmuch 
as the valuation of the moral conduct and mentality of 
individual members is rarely scientifically reliable. It 



232 ' THE EXCEPTIONAL CHILD 

is difficult enough to diagnose justly the case of a living 
child; to classify with any degree of justice and accu- 
racy the cases of the dead, through " field work" which 
relies upon circumstantial evidence, is a risky under- 
taking. 

Family data will never be trustworthy until we have 
a national system of vital statistics. Careful records of 
births and deaths and the accompanying circumstances 
should be kept, including as much of the parental his- 
tory as possible. These data should be accessible for 
the scientific study of every individual child. The 
medical fraternity can greatly help these studies by 
establishing to the best of their opportunity the history 
and etiology of each case under observation, and by 
carefully studying hereditary and congenital causes. 
Professional discretion will prevent physicians from 
making the facts thus discovered public. But it seems 
justifiable to expect their co-operation, by legal pro- 
vision and sanction if necessary, at least in cases of 
such gravity that the State and the community have a 
deep interest. A commission composed of experts should 
be created in every state or community, with full power 
to elicit all the obtainable information on any case. 

Mental Status of the Child. — A mere " scale of in- 
telligence," so-called, as for instance the Binet scale, 
can never give a valid measure of a child's status. There 
must be a thorough study of a child's history, environ- 
mental and physical ; there must be an understanding of 
his heredity, his education, and a number of other points. 
It is therefore refreshing to read Doctor Merrill's sen- 
tence: 1 "Any system of tests by which alone it is 

1 In the report on the findings at the Seattle, Wash., Juvenile Court, 
quoted before. 



EXCEPTIONAL DEVELOPMENT IN CHILDREN 233 

attempted to classify the child as being of a given men- 
tal age involves the fallacy of pseudo-exactness and 
needs carefully to be avoided." 

The Author's Own Larger System of Tests. — In his 
book, "The Study of Individual Children," published 
191 2 by the National Association for the Study and Ed- 
ucation of Exceptional Children, the author has ventured 
to offer a set of tests and investigations which, while 
by no means final, may illustrate what ought to be 
done. The complete form comprises the following 
schedules : 

First: a Child History, giving data previous to the 
time of examination. Second: a set of Body Measure- 
ments. Third: a system of Medical and Functional Ex- 
aminations. Finally: a scale of Physiopsychological and 
Mental Measurements which, in conjunction with the 
other investigations, will allow of some sort of definite 
conclusion as to diagnosis and treatment. 

Child History Data. — This part of the investigation 
endeavors to obtain as full etiological statements as can 
be obtained, referring to the family history of the case: 
Parents' and grandparents' station in life, physical and 
mental condition, cause of death, temperament, etc. A 
careful record of all children, living or dead (including 
miscarriages and still-births) is required. Information 
is also asked about other relatives. The child's own 
history refers to data about early infancy, nature of feed- 
ing, diseases, developmental data, etc. Then comes a 
description of the child. First, Physical Data are asked: 
Height and weight, condition of teeth, body peculiari- 
ties, etc. Second, Functions: Digestion, sleep, sense 
reactions, speech, etc. Third, Moral Status: Sexual de- 
velopment, filial relations, obedience, character in gen- 



234 THE EXCEPTIONAL CHILD 

eral and detail, etc. Fourth, Peculiarities and Habits: 
Conditions of fear, nervous conditions, general reactions, 
manners, etc. Fifth, Mental Status: Precocity or back- 
wardness, memory power, thought, imagination, judg- 
ment, school training, etc. Finally, General Symptoms: 
Errors of education, medical treatment, etc. 

Body Measurements. — These are of the usual an- 
thropometric type, including height and weight, chest 
expansion, girths, and diameters. Data on the child's 
individual rate of pulse, respiration, and temperature are 
added, to enable clearer judgment in the case of illness. 
The blank for these measurements is so arranged that 
monthly entries may be made for one year. The blank 
is for the use under conditions where longer periods of 
observation are granted so that the growth of the child 
and his development may be carefully studied. The 
measurements are supposed to be made without clothing 
not only to exclude the inevitable errors which clothing 
involves, but also to give immediate opportunity for 
closer physical observation, preceding a thorough medi- 
cal examination. Facts of scoliosis, round-shouldered- 
ness, skin abnormalities, deformities, flat-footedness, 
burns and scalds, etc., etc., can thus be at once put 
down. On the back of the entry blank, space is provided 
for such remarks which then can be utilized as a basis 
for further medical reference. 

Medical Examinations. — For these several different 
blanks have been provided, representing different stages 
and lines of observation and examination. 

The first of these is in the nature of a cross-section 
examination, to be made by the regular school physician, 
giving a general clinical picture of the child's physical 
condition. It refers to the general appearance and 



EXCEPTIONAL DEVELOPMENT IN CHILDREN 235 

nutrition of the child, and to simple facts about head, 
eyes, ears, nose, mouth, tonsils, and pharynx, neck and 
glands, chest, spine, abdomen, genitals, extremities, 
etc. 

The succeeding blanks require the co-operation of 
specialists and suggest such particular laboratory tests as 
will make the examination comprehensive. 

There are two anatomical sets. The first refers to the 
condition of the skeleton. It includes skull measure- 
ments, X-ray photographs of the carpal bones, etc. In 
regard to the significance of the development of the 
carpal bones, the late Doctor Thomas M. Rotch, of 
Boston, in his monograph, "The Development of the 
Bones in Early Life," came to the following conclusions: 

i. There is a manifest need for some developmental index by 
which physicians, acting as an advisory council to the people, 
shall be able to determine the fitness for school and for physical" 
work of the early years of life. 

2. The former means for this purpose are inadequate, whether 
by height, weight, teeth, statements of parents and guardians, 
or birth certificates. 

3. The physiologic test by the pubic hair worked out by 
Crampton 1 is an exceedingly valuable contribution, and if, as is 
possible, it correlates with a more practical anatomic index, will 
aid in deciding in doubtful cases. It evidently, however, is not 
from its very nature a test which should be widely used in 
schools, or courts, and it only covers a comparatively short 
period of life and is one which is not applicable to many ques- 
tions connected with early and middle school life. 

4. Physiologic conditions will probably be found to corre- 
spond to anatomic, and great credit should be awarded to Cramp- 
ton for his suggestions and work directed to the future discard- 
ing of chronological age as the most important guide in solving 
the problems of early life. 

1 Cf. later. 



236 THE EXCEPTIONAL CHILD 

5. Weight and height have long been known to be very inade- 
quate for determining chronological age, and have been conclu- 
sively shown to be so by Crampton. 

6. Pryor has shown conclusively, and my observations uphold 
his, that there is a marked difference in the anatomic develop- 
ment of children according to sex and family. 

7. The consensus of opinion among odontologists is that the 
eruption of the teeth as an index of age is illusive and very un- 
reliable. 

8. The skeleton represents an illustrative steel framework of 
development on which the body is built, and this development, 
when determined, presents the best source from which to evolve 
an anatomic index for practical use in the safeguarding of early 
life. 

o. The most important part of the skeleton for use as an index 
lies in the joints. . . . 

11. The carpal bones and the lower epiphyses of the radius 
and ulna represent the other joints to such a degree in so many 
instances, are so much more in evidence, and are so readily in- 
terpreted by the Roentgen method, that they can be practically 
used as an index of development, representing the entire bony 
framework. 

The second anatomical set refers to musculature and 
characteristics. It relates to a study of the peculiarities 
of the face in all its details, including symmetry and 
asymmetry, nose, mouth, ears, eyes, forehead, skin, in 
their anatomical meaning. Further, the mammae, ab- 
domen, genital organs, etc. With Crampton (cf. his 
publications as contained in bibliography at end of this 
book) the author lays great stress upon an investigation 
of the anatomy (and functioning) of the sexual organs. 
Referring to his remarks in various places in the chap- 
ters on delinquency and prostitution, he wishes to em- 
phasize the fact that malformations, tardiness or pre- 
cocity of development, disturbances in the functional 



EXCEPTIONAL DEVELOPMENT IN CHILDREN 237 

sphere of the reproductive apparatus are responsible for 
much mental and moral disorder. 

A third set of medical test-cards presents functional 
tests. They include tests of the special senses (vision, 
hearing, taste, smell, touch, temperature, muscular sense, 
balance) , some of them partly anticipated in the physio- 
psychological tests (which are mentioned later, but may 
be taken up before a child is referred to specialists for 
more thoroughgoing investigation) ; power of localization ; 
chorea tests, knee-jerk, habit spasms, neuroses, speech, 
dexterity, gait, appetite, digestion, heart action, lungs, 
urination, etc. Special reactions are also provided for. 

For institutional or prolonged observational work 
blanks have been provided for records of special regimen 
and diet, as well as a disease and treatment record. 

Educational Tests. — In the working out of those tests 
which are intended to probe the mental reaction of the 
child, a distinction is made between intelligence and judg- 
ment tests proper, and those which refer to physiopsycho- 
logical reaction. For example, the recognition and nam- 
ing of colors are not in themselves tests of intelligence; 
they depend upon the physiological ability to distin- 
guish color, and the ability to attach a name to a clearly 
differentiated color. A color-blind child will neither 
match nor name colors correctly, no matter how intel- 
ligent he may be. Again, the visual and aural memory 
span is of great importance, but it does not in itself 
vouch for intellectual strength. 

Physiopsychological Tests. — They present tests in 
color-perception and naming; visual and auditory dis- 
tance and accuracy; visual and aural memory; recogni- 
tion and identification of tones and harmonies; tactile 
tests; tests for acuteness in taste and smell; exercises in 



238 THE EXCEPTIONAL CHILD 

location and balance, etc. All these tests are carefully 
graduated. 

Mental Tests. — The mental tests proper are quite 
variegated. They include exercises in counting and 
naming things; language exercises, also using secret 
languages; following of directions; mental association; 
judgment; motor co-ordination; expression, and certain 
aesthetic reactions intended also to reveal emotional 
qualities. These tests are very full indeed, offering a 
large number of special exercises, such as building and 
manual construction, drawing, painting, and modelling. 
There are also such tests as will examine a child's prog- 
ress in reading, writing, composition, and number. His 
power of classification, of comparison, of deduction is 
under fire, and altogether there is such a composite pic- 
ture of his mentality produced that hardly any one of 
his faculties escapes testing. 

Arrangement in Periods. — The anatomical, functional, 
physiopsy etiological, and mental lines of development 
depend upon certain biological factors of growth. These 
have been reflected in the history of race development. 
As has been shown in previous chapters, it will be im- 
possible to draw clear lines of demarcation between the 
chronological years of a child's age as to his mental 
standard, inasmuch as the anatomical, physiological, 
psychological, and mental growths do not run in paral- 
lel lines, or at equal rates of speed, in all individuals. 
But it is feasible to mark off, in a general way, certain 
periods of development in a child's life, such as correspond 
broadly with the periods of race development, by way of 
a succession of ascending instincts and mental attitudes, 
in rate of reaction, in the matter of motor co-ordination 
and response, etc. 



EXCEPTIONAL DEVELOPMENT IN CHILDREN 239 

In the author's three books treating of this subject 1 
he has distinguished four such periods. As will be seen 
on page 41 of this volume, he has modified this division 
by splitting up the first of these into two. Thus he 
suggests five periods : the Infancy Period (from birth to 
2 or 3 years), the Primary Period (2 or 3 to about 6 or 
7), the Elementary Period (to about 11), the Intermediate 
Period (12 to 15), and the Advanced Period (16 to 21). 
These are further described on pp. 42 ff., and referred to 
frequently, so that it would seem the author's meaning 
cannot be mistaken. On page 167 reference is also 
made to Mr. Ellis's divisions. His two Childhood 
Periods cover about the same years as the author's 
Elementary Period; his Preadolescence corresponds to 
the Intermediate; his Early and Later Adolescence are 
somewhat parallel to the Advanced Period. There is no 
objection whatever to modifications of the division, and 
to appellations which indicate developmental periods 
from the point of view of sexual evolution; the principle 
is the same. 

The important point is that the author has endeavored 
to adjust his tests to these periods. He is fully aware 
of the fact, however, that even here the fines cannot be 
drawn hard and fast. Besides, as shown before, an 
individual child may pass through these periods nor- 
mally in certain lines of development, and unusually, 
or even abnormally, slow or fast, in others. Parallel 
development along all lines, and at the same rate of 
speed, is really an exception. This explains the differ- 
ence of mental type. The different mental activities 
are somewhat independent of one another, being local- 

1 "The Career of the Child," "Some Fundamental Verities in Educa- 
tion," and "The Studv of Individual Children." 



240 THE EXCEPTIONAL CHILD 

ized in different brain areas. Again, there may be and 
often is a distinct difference in the physiological growth 
rate from the rate of intellectual development. The 
one or the other may be retarded or accelerated, causing 
tension. Similar discrepancies may appear between the 
anatomical and the psychological development. Thus, 
the deductions to be made from the results of the tests 
have to be carefully checked up and adjusted. 

Conditions of Testing. — The objection may be sus- 
tained that such an extensive examination is impossible 
in general practice. As a matter of fact, this series is 
not intended for such purpose. In Chapter XVI of 
this book the author offers a more condensed set of 
tests for clinical use. But no rapid examination can be 
thorough and reliable; it tends toward fallacious deduc- 
tions. Even the strictest adherents of the Binet scale 
have been adding medical examinations and many other 
data to the scheme, and many Binet examiners have 
amplified the system itself by the introduction of further 
tests. One of the most ardent students of the Binet 
scale 1 assured the author that he considered it a grave 
error on the part of physicians, especially neurologists, 
to have fallen into the habit of using these tests in a 
rapid office examination of children for the determina- 
tion of their mental status. As has been stated before, 
even when a child falls three or more years below his 
chronological age — a condition which some think gives 
the Binet tests a chance of value — it has been found in 
numerous instances that the conclusion of intellectual 
inferiority is not always tenable, inasmuch as the child's 
opportunity for training has to be considered; and the 
kind of tests used, or passed, or missed, must be taken 
1 Professor Terman of Leland Stanford University. 



EXCEPTIONAL DEVELOPMENT IN CHILDREN 241 

into account, so that we may not have a warped 
picture of his mentality. Besides, a child's chronolog- 
ical age, it has been shown, is no index of his develop- 
ment. 

An investigation like the one suggested in this chap- 
ter will obviously extend over some period of time, and 
cannot be completed in one sitting. Only so much 
should be done in one examination as can be accom- 
plished without straining the child. Measurements and 
medical examinations have to be undertaken under 
proper conditions. 

In courts the detention home should be developed into 
an observation clinic, where tests and examinations can 
be made at leisure and under easily controlled condi- 
tions. An observation clinic, or observation school, 
equipped with the proper apparatus and under the direc- 
tion of specially trained persons, should be established 
in connection with every school system. Truant schools 
and similar institutions should afford ample opportuni- 
ties. Many of the children needing examination and 
observation would not have to be altogether removed 
from their ordinary surroundings if there is a system of 
clinics for the special work. Much of the testing can 
be done in the school itself, in the schoolroom, upon a 
group of children at the same time. Many of the tests 
are so arranged that they can be made part of the actual 
schoolroom work. In a measure they may be utilized in 
place of the traditional examinations, to determine a 
pupil's maturity for promotion. Other tests are of such 
a nature that they can be done in rest and recreation 
periods, appealing to the children's play spirit; or in the 
workshop, the school-garden, etc. 

In special institutions for the study and training of 



242 THE EXCEPTIONAL CHILD 

exceptional children, the opportunities are, of course, 
unlimited. 

Instructive Cases. — To illustrate a few of the points 
made in this chapter, also on previous pages of the book, 
several cases from the records of the author may here 
be briefly reported, omitting a mass of details which are 
on file. The first two cases were referred to the author 
by the Juvenile Court of San Francisco, in 1913, and 
examined by him in the clinic established in that city 
by the National Association for the Study and Educa- 
tion of Exceptional Children, with the assistance of 
Doctor Ernest Bryant Hoag. The tests were abbrevi- 
ated in their cases, but followed the general lines of this 
system. 

Case 60, F. C, boy, aged 15 years. — Reported because he was 
unable to retain a job, and had become practically a vagrant. 
The mental tests proved him to be intellectually very imma- 
ture, generally representing the primary level, and certainly 
grossly unschooled. His physical condition showed the under- 
lying causes of much of his difficulty. He should have had 
special treatment for many years past. Septum deflected on 
right side of nose, with great obstruction to breathing; nasal 
catarrh. This constituted so constant an irritation that it 
required immediate surgical relief. Hearing was reduced by 
two-thirds in right ear, with occasional discharge, indicating 
otitis media and calling for treatment to prevent further deaf- 
ness. The boy proved to be an epileptic, with attacks dating 
back at least two years. On the basis of these findings the fol- 
lowing report was sent to the court: "The boy is unable to 
undertake independent employment. Should have surgical re- 
lief and be placed in a home for epileptics, where also his man- 
ual faculties may be developed. He is entirely unfit for educa- 
tion in the public schools." 

Case 61, J. F., boy, aged 16 years. — Had been arrested for 
repeatedly attacking his father, even his mother, and not doing 
well at anything. When brought to clinic, he was handcuffed, 



EXCEPTIONAL DEVELOPMENT IN CHILDREN 243 

sullen. His mental development was found to be exceedingly 
uneven. He showed much power of rational judgment, to- 
gether with singular retardation in specific applications. He 
gave the impression of a mentally neglected child. He repre- 
sented a transition period from childhood to adolescence, with 
all the mental disturbance characteristic of that epoch. Emo- 
tionally he was under a distinct strain, being sullen and antago- 
nistic under unsympathetic influences such as his home pre- 
sented; but yielding immediately to personal sympathy. He 
was hardly mature or trained enough for independent work. 
The medical examination revealed catarrh of the throat, en- 
larged turbinates which obstructed the nasal passages, and a 
long, adherent prepuce. Nasal treatment and circumcision 
were indicated for immediate relief, and it was suggested that 
he be placed away from home somewhere where he would have 
firm but kind discipline and special training without stigma. 

His case suggests the fact that it is easier to make 
recommendations than to have them carried out. At 
the present time there are hardly any places in existence, 
under public control at least, which would have given 
this boy a chance. Reformatories, so-called parental 
schools, and the like, as they are now conceived and 
organized, are not the places required in such a case. 

The following cases have been under observation in 
the east, in part in the institution for atypical children, 
Herbart Hall, at "Watchung Crest," Plainfield, N. J. 

Case 62, G. S., hoy, aged 15 years at time of complete exami- 
nation. Parentage very good, easy circumstances. Father is 
quite deaf from catarrh of long standing, also exceedingly ner- 
vous, and G. is strikingly like him. He was the fourth child 
among seven, three of whom are dead. Prenatal conditions 
very favorable, but child was wakeful and nervous from first 
breath and wore his mother and competent nurses out com- 
pletely. At 2 had a bad fall which caused two collapses; lived 
only on account of stimulants being administered. After that 



244 THE EXCEPTIONAL CHILD 

time he was a bad stammerer. Very left-handed. Morbidly- 
afraid of fire — generally morbid symptoms of fear; also brooding 
and melancholic about his own condition. Backward in school. 
Given to tempers. Diminutive in size for his age, and sexually 
underdeveloped. Very defective eyesight, through muscular 
insufficiency. Readily fatigued. He had no visual perspec- 
tive, owing to his defect. His visual and aural memory span 
was limited. 

A year after first reported, had improved splendidly under 
training, in every direction. He had acquired considerable 
ability to concentrate and to endure, also to control his speech 
defect and morbid traits. His backwardness had been over- 
come to a large degree since his difficulty was understood, and 
he was bright and responsive, eager to progress. Organized 
manual work, especially work on a large scale outdoors, helped 
him to acquire muscular control and to improve generally in 
physiologic function. In contrast to this he developed manual 
dexterity with a distinctly artistic touch in producing small and 
minutely executed models of houses, boxes, picture-frames, etc., 
also in drawing. 

After two years he left Herbart Hall. When he reached home 
(he had not been seen by his relatives for the entire period) his 
mother wrote that she was amazed at the change which had 
come over the boy. "When he entered your school he was 
melancholy and backward and with a poorly developed body. 
And now he is happy and brimming over with ambition in every 
direction." 

Case 63, R. F., boy, aged 17 years. — Of good appearance, 
above average in size; good conversationalist and apparently 
intelligent, with ability to do a number of ordinary things. 
The son of wealthy parents, he had never done well, had no 
great filial affection, and had recently drifted into bad habits, 
undesirable companionship, even delinquency. The medical 
examination was largely negative, except that circumcision was 
strongly indicated to correct preputial hypertrophy and his 
bad sexual habits. The mental tests revealed some of the 
causes of his somewhat shiftless and dangerous life. Visual and 
aural memory very poor; what was retained was not in proper 
order. Muscular memory unreliable, sense of balance impaired. 
Reproduction of oral information only fair. The judgment 



EXCEPTIONAL DEVELOPMENT IN CHILDREN 245 

tests showed distinct weaknesses; where he succeeded he needed 
much time and the opportunity of a second and third attempt. 
His methods in manual and art expression were distinctly 
primitive. In language he was quite proficient and could talk 
very intelligently; yet, when he was to formulate his thought 
in writing he was vague and loose in construction. It was plain 
that this boy, having grown up without the proper recognition 
of the special training he needed, could profit little from ordi- 
nary school instruction and influences. When let loose he had 
no perspective of situations and causal relations and could not 
learn quickly enough from experience, owing partly to his un- 
reliable memory. He had, however, sufficient intelligence at 
bottom to be helped toward considerable improvement through 
a kind of training which took his needs of organization of his 
mental outfit into consideration. The atmosphere of his sur- 
roundings counted a great deal. He became a very tractable 
and very much better boy, and had good prospects of a brighter 
future if he could have been long enough under the reconstruc- 
tive influences. 

Case 64, L. D., boy, aged 17^ years. — His mother suffered 
from shock in the sixth or seventh month of pregnancy, owing 
to father's sudden death. One aunt, very nervous tempera- 
ment, asthmatic, died of Bright's disease. Language developed 
slowly and indistinctly after 2 years of age. At 16 was circum- 
cised; much excited over operation and nearly died from heart 
failure during anaesthesia. When a little boy, was frightened by 
a horse running after him; fell and broke his arm. Used to be 
morbidly interested in funerals; talks about the coffin he wants 
to be buried in. Barely escaped being placed in an institution 
for the feeble-minded. He had been unmanageable, inefficient, 
morbid, with suicidal tendency, backward, and given to several 
forms of sexual perversion. Medical examination gave a clew 
to his mental difficulty. Weight and height above normal, 
making him very heavy for his age. Flat-chested; heart-beat 
somewhat weak and rales in right lung. Network of varicose 
veins on both buttocks. Sexual organs showed contrasting de- 
velopment: overgrown penis, with entirely undeveloped testi- 
cles. Had been masturbating since childhood; indulgence in 
homosexual practices resulted in funnel-shaped rectum, which 
caused chronic constipation. 



246 THE EXCEPTIONAL CHILD 

Careful exercise in the open air and special treatment relieved 
these serious conditions so markedly that a great change came 
over the boy. His sexual inverted acts ceased. His mental 
tests, after his main difficulties were removed, proved very sat- 
isfactory, showing him to be a mentally normal boy, with 
creditable power of judgment, logical and associative faculty, 
and good concentration. His memory span in visual and aural 
impressions remained narrow, and he had difficulty in graphic 
and constructive expression, being rather primitive in these 
things. The boy was plainly capable of considerable advance- 
ment, and with the further improvement of his physical condi- 
tion there came a gain in temperament, application, and per- 
spective. But as he had come under treatment too late, his 
psychopathic conditions reasserted themselves later and his 
reinstatement failed. 

Case 65, D. T., boy, now 20 years old. — Distinctly primitive. 
To call him feeble-minded in the accepted sense would seem a 
superficial valuation. He is still very backward in his school 
studies, and did some absurd things in his judgment tests. 
Yet in others, those that required action of some kind, he did 
remarkably well, showing considerable penetration and quick- 
ness to learn a new thing. Thus, he learned to do all the five 
tests with the Knox cubes; connected one hundred dots ration- 
ally and immediately; was normal with his form board and the 
dissected pictures (graded series), etc. His drawbacks were, 
first, his extreme slowness of response, and, second, his very 
narrow memory span, both visual and aural. They account for 
his difficulty in learning and in building up a conceptual world 
on the basis of experience, for he cannot well learn from his so 
easily forgotten errors and experiences. The boy showed other 
faults which would stamp him ordinarily as a criminal. He had 
dirty personal habits and a strong inclination to pilfer eatables 
and glittering things, jewelry, money, etc. The money could 
have had no attraction to him, as he understood little of its 
value; neither had he any conception of the value of jewelry. 
There was simply the attraction of the tempting objects and 
the tendency to hoard, even though he forgot the hiding-places. 
Again, even when he had had a full meal, he would steal eatables 
in large quantities and gorge himself to nausea. All these traits 
are distinctly those of savage people, and would be altogether 



EXCEPTIONAL DEVELOPMENT IN CHILDREN 247 

normal among Igorots, New Zealanders, and the like. In other 
respects the boy showed intelligence, was good-hearted, com- 
panionable, and unselfish, liked to work on a primitive level, 
and was as harmless as a child. 



CHAPTER XIII 
AS TO STANDARDIZATION 

Tendency to Establish Standards. — The tendency of 
the times is to establish "standards of efficiency," 
"age standards/' "class standards," standards in every 
branch of study in schools, in every line of human occu- 
pation, in business, in factories, etc. The work of the 
statistician is highly valued. Everything is to be ex- 
pressed in quantitative terms. Schemas, curves, and 
other methods of graphic representation are widely ap- 
plied. All these efforts have their importance and sig- 
nificance and are an expression of the modern desire for 
scientific accuracy of statement and procedure. 

Standardization of Mental Tests. — The principle of 
standardization has also been applied to tests for mea- 
suring the mental capacity of children. It has been one 
of the reasons for the quick popularity of the Binet Tests 
that they seemed to lend themselves easily to a stand- 
ardization of results. Each test had been placed in a 
definite group representing what was called "mental 
age." The "mental age" was to be computed in a 
simple manner from the data obtained, on a numerical 
basis, and the examiner received the impression that 
he had arrived at a definite conclusion. 

Difficulties Encountered. — The author has often been 
importuned to standardize his own tests in a similar 
manner, but has always hesitated to do so. It is true 
that, while the division of a child's life into "mental 

248 



AS TO STANDARDIZATION 249 

years" has seemed impossible to him, as the differences 
in type will constantly confuse results, he has endeav- 
ored to establish developmental periods as a basis of 
judgment. Even these, however well established as 
they may appear to be in regard to the main points 
(budding instincts, interests, abilities, tendencies, etc.), 
merge into one another so gradually that no hard-and- 
fast lines of demarcation can be drawn. In the develop- 
ment of the various characteristics of a certain period, 
or " culture epoch," there are hardly any two capacities 
or elements that develop at the same rate of speed 
of energy, so that, as has been shown elsewhere in this 
book, a given individual may be said to represent in 
reality various periods at the same time, being primitive 
in some mental manifestations, and modern in others. 

Placing of Details. — A contention may be made that 
at least these various elements of development should 
be definitely placed in a scale of advancement. This 
the author has tried to do in a general way. He is also 
using the scales of standardization elaborated in psy- 
chological and other laboratories for certain particular 
tests. It is furthermore quite evident that the child 
who can complete forty of the completion test sentences 
(New Series of Tests, Language Test No. 3) , or who can 
give thirty opposites out of forty (Language Test No. 5), 
is further advanced in this particular thing than another 
child who can complete only ten sentences and find 
fifteen opposites. Similarly, the degree of perfection 
with which any test is performed will allow conclusions 
as to the relative mental development in regard to that 
particular performance. But just as we have proof now 
that there is no such thing as "formal training," that is 
to say, that training in such branches as arithmetic, or 



250 THE EXCEPTIONAL CHILD 

grammar, has no value beyond training in these subjects 
and does not necessarily produce greater proficiency in 
other subjects — just so development in any particular 
mental performance is not in itself proof of broad or 
general mentality on a corresponding level. The tests 
will reveal the performance level, but each of the per- 
formances stands, as far as the test goes, first merely on 
a qualitative basis. To suggest a definite quantitative 
method of recording the degree of perfection, and then 
computing from the data thus obtained the mental and 
moral status of a child, would seem preposterous. 
Whenever definite experiments are arranged in a psy- 
chological or pathological laboratory, they are intended 
to test and valuate specific reactions. A number of 
these reactions have to be compared and qualitatively 
balanced to allow of deductions which will throw light 
on the mental status. 

The Personal Equation. — The author is reminded of 
an interesting statement made by a well-known inves- 
tigator who has applied many different tests on a large 
number of subjects. In regard to the Binet scale he 
gave it as his opinion that in valuating the different 
answers the examiner is much influenced by his own 
sizing up of the situation, and of the kind of responses 
the child gives. In other words, the personal equation 
enters widely into the computation of results. That is 
the reason why child-experts must make these tests — 
those who understand child nature — and not persons 
who give the tests mechanically. For in reality the 
Binet Tests, as well as many others of a similar nature, 
are so simple that it might be thought any intelligent 
person can give them and compute the results. "If," 
said this investigator to the author, "the child who is- 



AS TO STANDARDIZATION 251 

being examined were placed behind a screen so that the 
examiner would not see him, simply putting down his 
answers, the inefficiency of these tests would at once be 
established. For their real value, as far as they have 
served their purpose, has depended upon the judgment 
of the examiner, which was added to the test in its 
mechanical construction." 

Tests Merely Methods of Approach. — In considera- 
tion of the complex nature of the child, with its physical, 
emotional, and mental aspects, also in view of the very 
variable element of schooling and education, environ- 
mental conditions and personal experience, the author 
feels that we should refrain at the present time from 
trying to establish any definite standards and cate- 
gories. No two children will answer the same question 
in the same way; no two children will understand the 
same question, if put in the identical words, in the same 
way. There must, therefore, be wide limits, even in 
the matter of putting the tests. 

Doctor Robert M. Yerkes, of the Psychopathic Hos- 
pital, Boston, has developed what he calls a "point 
scale" for the measurement of intelligence. In this he 
uses Binet and other tests, but grouped in a manner of 
his own. Each test is grouped by itself, in graduated 
form, the performance becoming more complex and 
difficult in detail. A certain number of points is credited 
to the subject tested according to the performance level 
he reaches. So far the attempt at standardizing is in- 
teresting and instructive. But then Doctor Yerkes pro- 
ceeds to establish mental age norms by scoring, so that 
e. g., 17 points indicate a "mental age" of 4, 55 points 
a mental age of 9, etc., meaning that a "normal" child 
of these ages should score at least that number of points. 



252 THE EXCEPTIONAL CHILD 

The science of child-testing is so very young yet that 
it would be disastrous if we should allow ourselves to 
be guided by a more or less mechanical scale, in placing 
a certain mental manifestation in a certain definite place 
of quantitative value, and judging a child accordingly. 
We may have to revise our standards continually on the 
basis of further experience, It is for this reason that 
we must use any kind of tests simply as systematized 
methods of approach, and otherwise apply with fairness 
and common sense our own standards of experience and 
judgment. 



CHAPTER XIV 

THE BINET SCALE OF INTELLIGENCE 

Its Value for Comparison. — In the extensive system 
of tests sketched in Chapter XII, mention is not made 
of the Binet scale, except by way of criticism. The 
author does, however, apply it in the modified form 
suggested by the late Doctor Edmund Burke Huey, in 
his book on "Backward and Feeble-minded Children." 
The purpose of its use in this schedule is to check up 
results and to allow of comparisons. Even Huey's 
modification, however, the author felt constrained to 
amend in certain places. 

The Author's Amendments. — The pictures suggested 
by Binet he does not use at all, as they hardly portray 
American life. He has used some of the colored pictures 
selected by Doctor Goddard of Vineland as far more 
suitable, portraying as they do life and action, such as 
may be found anywhere in our country. At times any 
picture of a suitable nature which was handy was sub- 
stituted, even silhouette drawings illustrating fairy-tales, 
and others which represented child life in various forms. 

For the drawings in which "pretty" is to be distin- 
guished from "ugly," and in which missing eyes, mouth, 
nose, and arms are to be detected, the author has been 
using much enlarged forms in place of the rather diminu- 
tive originals. 

In place of two dimes, used in test 36 for the mentality 
of 9 years, he uses a quarter, as it would seem absurd 

253 



254 THE EXCEPTIONAL CHILD 

to give two dimes for an article costing only four cents. 
This change, while modifying the arithmetical process 
somewhat, does not seem to vitiate the purpose or 
grade of the test materially. 

The questions of comprehension, under No. 44, men- 
tality of 10 years, were not modified by the author, 
although they impress him as singularly clumsy, badly 
worded, and referring to emergencies and conditions 
which are not altogether common in the experience of 
an "average" child of that age. 

The nonsense sentences, under No. 46, mentality of 
11 years, contain so •much that is grewsome that the 
author felt constrained to substitute others. Under C 
(for which both Binet and Huey give the story of a 
young girl cut into eighteen pieces) he substitutes the 
following: 

It was a bright day with a blue, sunshiny sky, when I took 
a walk. Suddenly I saw a big tree fall across the road. I 
thought at once that the lightning from the storm-cloud over- 
head must have struck it. 

Under D (for which both Binet and Huey give the 
story of a railroad accident) he substitutes this: 

Yesterday a poor boy lost his pocketbook. But his loss was 
not serious, as he had only $50 in his pocketbook. 

Under E he uses Huey's example. 

Similarly, in the group of tests for 1 2 years, the writer 
has eliminated the first of the incomplete stories. Such 
a horrible experience as seeing a dead person hanging 
from the limb of a tree seems to him to be not only far 
beyond the natural experience of a child (would it be 
otherwise in France?), but altogether appealing to a 



THE BINET SCALE OF INTELLIGENCE 255 

morbid imagination, which ought not to be stimulated. 
He has substituted the following story, which has a 
humorous strain: 

Last night I was awakened by a terrible noise. I got up, 
greatly frightened, and looked out of the window. It was dark, 
and first I could not see; but the noise kept on. There was a 
screeching and whining and running, as if many people were 
in the yard in great distress. Then the moon came out and I 
saw (after a pause) — what? 

The story should be told with a twinkle in the eye of 
the examiner. The proper answer would, of course, be: 
Cats fighting. Some people might think of dogs rather 
than cats; their answer would be acceptable. The situ- 
ation is one which is experienced in both city and coun- 
try life. 

Criticism of the Binet Tests. — It is hardly necessary 
to enter here into a lengthy discussion of the Binet Tests, 
as a great deal has already been written about them, 
and occasional remarks are scattered through this book 
at appropriate places. Only a few things should be 
mentioned to illustrate why the author lays relatively 
little stress upon results obtained from them. 

Language Tests. — Much of the series is based upon 
a child's ability to use language intelligently. While, 
generally speaking, a careful observer will deduct much 
information from a child's linguistic expression, it must 
not be forgotten that language develops with very dif- 
ferent degrees of rapidity in children. There are per- 
sons who will never achieve much power of verbal ex- 
pression without detriment to their general intellectual 
ability. The writer is not unaware of the wonderful 
effect verbal expression has upon clarifying a thought; 



256 THE EXCEPTIONAL CHILD 

but thought may be expressed in various ways : through 
drawing and construction, through sculpture, or through 
gesture (as in dramatics), without language being re- 
quired. Reading and writing are not arts which are 
deep-rooted in man's civilization, and there are levels of 
culture in which they play a minor part. Again, cer- 
tain anatomical conditions and the psychopathic condi- 
tions of alexia and agraphia will produce practical illiter- 
acy without affecting the mental capacity in the same 
degree. 

Language efficiency also depends much upon environ- 
mental conditions and opportunity. Doctor Margaret 
Otis has made an interesting investigation of delinquent 
girls by the Binet method. She did not find the results 
very helpful. The girls failed markedly in the language 
tests. She explained this failure as follows: 

The girls come from a class in society where fluency in lan- 
guage is not a pronounced characteristic. They have had no 
training in expressing thought either at home or at school, for in 
examining the question of school training we find that most 
of the girls have had little or none. The average age of the 
girls examined . . . is 17, while the average age at which they 
leave school is 13. . . . The average grade of school work 
reached is the fourth. . . . Four girls of the total number (172) 
reached high school, while seven had no schooling whatever. 
Fifty-seven left school before reaching the age of 14. With 
such limited school training it is no wonder that the girls lack 
the ability to express themselves, and show themselves deficient 
in the language tests, for the ability to use language depends 
more than any other on training, whether at school or at home. 
. . . These (Binet) tests alone do not tell all we wish to know 
about delinquent girls. 1 

l Cf. "The Binet Tests Applied to Delinquent Girls," in The Psycho- 
logical Clinic, October, 1913. 



THE BINET SCALE OF INTELLIGENCE 257 

This experience is very interesting in view of the 
claim made for the Binet method that its application is 
independent of the school advantages of the children 
tested. 

A strange corroboration of the inefficiency of these 
tests even when children have had the advantage of school 
training is given by Margaret S. Prichard, head of the 
department of psychology, Philadelphia Normal School 
for Girls, in a paper read in the autumn of 1914, in which 
she says: "The Binet scale . . . has been found to be too 
crude to be used for grading pupils in a class. For this 
purpose one must use a combination of tests, and it is 
significant that Stern proposes to gauge the value of 
the results obtained by comparing them with the esti- 
mate of the teacher. . . ." x 

Color Tests. — We may also consider the color test 
for the mentality of 7 years as being of doubtful value. 
Binet distinguishes between "color -perception" and 
"verbalization of color," claiming that the former is 
often very keen with even young children, while the 
naming is normal for the age of 7. But the color- 
blind child, even at the age of 7, may not be able 



1 It may be mentioned in this connection that an investigation by 
Rudolf Pintner and Donald G. Paterson, of the Ohio State University 
(published in The Journal of Educational Psychology, April, 191 5). shows 
"that the Binet-Simon scale as it now stands cannot be applied satisfac- 
torily to deaf children " A strange observation may be made, viz., that 
a number of investigators discover the inadequacy of the scale for their 
particular work — but rarely fail to add that it would possibly be usable 
in other fields, or that it might be amended, and enlarged, or what not — 
as if the Binet scale, as stick, were a sacred thing, not to be touched 
under the charge of treason or sacrilege or " unscientific attitude." They 
fail to recognize that their criticisms, especially when they are combined 
and compared, in the aggregate, go to the very root of the Binet princi- 
ples. 



258 THE EXCEPTIONAL CHILD 

to distinguish the four colors — red, green, blue, yellow — 
without error in naming, so that color-matching tests 
should precede the naming test. It must also be con- 
ceded that even the proper naming of colors in an other- 
wise normal child depends somewhat upon his oppor- 
tunity of training. 

Weight Test. — The weight test is considered by Binet 
"as one of those which best detect intelligence without 
culture, as it is absolutely independent of all instruc- 
tion." At the same time he remarks "that the kind of 
intelligence indicated by it is of a very special nature. 
There are some children, very intelligent otherwise, who 
fail to arrange these boxes, while others do so accurately 
and with facility." Very true. But if this is so, why 
should such a test be included in a series intended for 
the testing of general intelligence ? 

Repetition of Words and Numerals. — A particular 
feature of the Binet tests is the repetition of an increas- 
ing number of numerals, and of syllables arranged in 
words and sentences. This is distinctly a test of aural 
memory, not of intelligence. In discussing the results 
of these tests, Binet admits "decidedly the power of 
memory does not increase greatly with age." Why, 
then, is this feature of the tests so prominent? 

The Test of Sixty Words. — A difference of types, simi- 
lar to the one admitted by Binet in the matter of weight 
conception, is recognized by him in reference to the test 
requiring the saying, or dictating, of at least sixty words 
in three minutes. In valuating results he counts only 
the number of the words given by the child, although 
he confesses that "the use of series of words and of 
abstract terms indicates a certain amount of intelligence 
and culture." This very important qualitative element 



THE BINET SCALE OF INTELLIGENCE 259 

is neglected in judging of the result of the test. The 
intention is to estimate "both the intellectual activity 
of an individual and his verbal type (the italics are the 
author's). Those who have many words at command, 
those who think in words, those who habitually think of 
abstract subjects, or those who are fond of puns, appear 
to have the advantage over others." The non-linguistic 
child, the child who does not habitually think of ab- 
stract subjects, the child whose talent is along graphic 
and constructive lines, will here make a bad showing. 
Likewise the timid, the reserved, the silent, the stolid 
child. And Binet's admission throws an interesting 
sidelight upon the author's contention in regard to the 
language tests criticised before. 

Binet Results and School Standing. — It has been 
claimed that the results of the Binet Tests tally well 
with the general standing of a child in school. This 
has been taken as a vindication of their value. As a 
matter of fact, it would prove that this method tests 
practically the same faculties and types of response as 
are required in ordinary school work, so that the tests 
would seem superfluous. What we do need is some- 
thing that goes "behind the returns," so that we may 
know why it is that a child has a certain rank in school. 
In many instances ordinary school work does not appeal 
to those children who offer difficulties, and their train- 
ing must be of a different kind. It is also instructive 
to compare this claim that the tests tally with the 
school standing of a child with what has been stated 
by Professor Prichard as quoted on page 257. 

Mechanical Computation. — The rules for computing 
the mental age of a child according to the Binet Tests 
are as follows: 



260 THE EXCEPTIONAL CHILD 

The child has the intelligence of that age all the tests of 
which he succeeds in passing. Here is a child 9 years of age 
who passes all the tests for the seventh year; he has then at 
least the intelligence of a child of 7. After determining the 
age for which a child passes all the tests, a year is added to the 
intelligence age, if he has succeeded in passing five additional 
tests belonging to superior age groups; two years are added if 
he has passed ten such tests; three years if he has passed fifteen, 
and so on. 

Thus a child passed the five tests for the eighth year; he has 
the intelligence of 8 years; in addition he passed three tests for 
9 years and two tests for 10 years; we add one year for the 
five tests, the record stands 8 + 1 = 9, an d the child has an 
intelligence of 9 years. Another example: A child passed the 
five tests for 6 years; he has the intelligence of 6 years; he also 
passed three tests for 7 years, three for 8 years, two for 9 years, 
two for 10 years, and one for n years; this gives him eleven 
extra tests, and adds two years to his intelligence age, making 
it 8 years. 1 A last example: A child passed all the tests for 
4 years; he passed in addition one test for 5 years, three for 
6 years, two for 7 years, four for 8 years, three for 9 years, and 
two for 10 years; he has passed, then, fifteen additional tests, 
which is equivalent to three years, and he is accorded the mental 
age of 7. 

This method of computation, in the first place, omits 
a consideration of the tests below the age in which a 
child tests full. Suppose a child tests full for 6 years, 
passing all the tests for that level; but he did not pass 
full in any of the previous groups, passing only two or 
three tests in any of them. What then ? What signifi- 
cance has that in the computation of results ? All of us 
know that such cases are quite frequent. Again: Sup- 
pose a child does not pass all the tests in any age group 

1 Some American investigators would mark his mental age 8.1. A more 
recent method is to use the basal year, only adding the number of addi- 
tional answers in the form of an exponent, like this : 6 11 . 



THE BINET SCALE OF INTELLIGENCE 261 

— and even that has happened — which is then the start- 
ing-point for any kind of computation ? 

Finally, the mechanical way of computing the "men- 
tal age" of a child destroys much of the good that may 
be found in the Binet Tests for comparative valuations. 
For the test units, after all, refer to different mental 
qualities and faculties; some to the power of memory, 
others to those of discrimination, of language, of logical 
definition, etc. Suppose a child of 8 years would pass 
all the tests up to and including all for the mentality of 
6 years. Even if he passed only those for 6 years, the 
result in the Binet computation would be the same: he 
would be put down as having a mentality of 6 years. 
In addition he would succeed in responding to Nos. 26 
(counts 13 pennies), 30 (names red, green, blue, yellow), 
32 (counts from 20 to 1), 33 (names days of week), 35 
(repeats 5 numerals), 39 (names the months), 43 (re- 
peats 6 numerals), 48 (gives at least 60 words), 51 
(repeats 7 numerals), and 53 (repeats sentences of 23 to 
26 syllables). These additional ten answers would give 
him two more years in mentality, or place him on the 
normal level for his age. But what about his intelli- 
gence? He has given evidence of a good memory of 
words and numerals. But is he equal in intelligence to 
another normal child of 8 who was able to answer the 
remaining questions, 27, 28, 29, 31, and 34 (using Huey's 
enumeration), which are intended to test the child's 
faculty of judgment and discrimination? Illustrations 
of this kind can be multiplied. Of course, if we con- 
sider that Binet and Simon do not base mental power 
on the power of judgment, but make a puzzling distinc- 
tion between judgment and the intellectual level, we may 
understand why they ignore these differences of type. 



262 THE EXCEPTIONAL CHILD 

Mental Age and Judgment. — It is instructive to find 
that this distinction is not made by all who use, and 
think they understand, the Binet scale. The February, 
1914, number of the Journal of Educational Psychology 
contains some suggestions and recommendations made 
by members of the International Congress for School 
Hygiene on the Binet-Simon scale. Among these is 
this statement: 

We believe that current misconceptions as to the aim of the 
scale should be removed. It is not intended to test the emo- 
tional or volitional nature, but primarily intelligence (judg- 
ment). 

The parenthesis shows that the distinction between 
intelligence and judgment made by Binet himself is not 
made by these workers. 

Binet Tests and Feeble-Mindedness. — The recom- 
mendations mentioned in the previous paragraph con- 
tain several other interesting statements. In a conver- 
sation Mr. Alexander Johnson, of Vineland, an expert in 
feeble-mindedness, stated that he did not consider the 
Binet Tests as more than a rough-and-ready method of 
grading the feeble-minded so as to distinguish between 
the various grades of mental defect without attempting 
to make finer distinctions. He did not think that these 
tests gave reliable information beyond the "mental age" 
of 10. Now, this expression stands in contrast to the 
following contention of the school hygiene experts as 
quoted before. They say {loco cit.) : 

The scale does not always furnish a sharp, nor a positive 
diagnosis of feeble-mindedness; in particular: 

(a) A mental age of 10 or above is not necessarily indicative 
of feeble-mindedness, regardless of how old the examinee may 
be, and 



THE BINET SCALE OF INTELLIGENCE 263 

(b) A young child may test almost at age and yet be feeble- 
minded as determined by other criteria. 

Thus, the usefulness of the Binet Tests in investiga- 
tions of this kind is distinctly limited. 

Doctor Fernald says: "The Binet Tests corroborate 
where we do not need corroboration, and are not deci- 
sive where the differential diagnosis of the high-grade 
defective from the normal is in question." 

Judgment of the Examiner. — Binet himself admits 
that in spite of the system of marking which he and his 
coworker Simon have devised, they believe that the 
experimenters must judge 1 of the responses which are 
made. He says: "Our method is not an automatic 
weighing machine, such as the scales of the railroad 
stations which print an individual's weight entirely un- 
aided." In fact, he states: 

The researches which have enabled us to calculate our norms 
were made in those primary schools of Paris which are situated 
in the poorer districts. Experience has demonstrated that the 
children of persons in easy circumstances present in general a 
higher intellectual development than that expressed by our 
means. Thus, in a private school frequented by the bour- 
geoisie, and where the classes consist of from eight to ten pupils, 
the pupils show a mean one and one-half years in advance of 
our normal means. It is important to add that our examina- 
tions have been made but once, and by a stranger, who, with- 
out intimidating the child, inspired him with a certain defer- 
ence. Other results would be obtained if the examination were 
repeated several times or if it were conducted by a person too 
well known to the child to produce a deferential attitude, etc., 
briefly, if the very precise conditions which we have indicated 
were ignored. 

»C/.p. 251. 



264 THE EXCEPTIONAL CHILD 

These admissions are indeed very illuminating. That 
results obtained in this wise should have been readily 
accepted in this country as standards is one of the 
strange things in the development of science which 
astonish the historian. 

Mental Quality. — All this goes to show that after all 
is said the Binet Tests are not the last word in gauging 
a child's mental development and ability. The Binet 
scale fails to reveal the quality of a child's mind, and 
after all it is this quality alone which is of educational 
value, and the determination of which helps us to make 
an educational diagnosis and prognosis. It is most in- 
teresting to quote Binet's own words, in which he con- 
cedes this very fact. He says: 

If one relied wholly upon the results of our measuring scale, 
one would not be able to grasp the mental differences which 
separate an imbecile from a general paralytic. Shall we con- 
clude that these subjects have the same mentality? Evidently 
not. We must put our readers on their guard against this 
erroneous interpretation of the bearing of our measurements. 
The scale which we use is constituted by a series of small prob- 
lems of intelligence, and it is quite possible that two individuals 
fail in the same problems without, for that, having similar men- 
talities. The practical consequence, the efficiency of their men- 
tality, is the same, but the mentalities may be different. 

Our scale resembles very much a standard, which instead of 
measuring height, measures the intelligence; but just as the 
ordinary standard gives no information regarding the normality 
of the corporal development, and may indicate the same num- 
ber of centimetres, for a normal child and for an adult hunch- 
back, so our scale gives the actual level of mentality, without 
analyzing it and without giving any information as to its type. 

In the light of other admissions, it is very doubtful, 
indeed, whether the scale gives even "the actual level 



THE BINET SCALE OF INTELLIGENCE 265 

of mentality," or "the practical consequence, the effi- 
ciency of their mentality." 

Other Admissions by Binet-Simon. — Other interest- 
ing confessions of the authors of the scale are these: 

Several tests admittedly cover several years, or stages, 
of mental development, thus giving weight to the differ- 
entiation of periods rather than of "mental years." 

Wilkin the "mental years," they distinguish between 
"bright ones" and duller ones. 

They find it "very difficult to distinguish between the 
intellectual levels of seven and eight years," while on 
the other hand they recognize "the enormous advance 
from the point of view of language which takes place 
between six and seven years," thus again corroborating 
the advisability of distinguishing periods in preference 
to mental ages. The sixth year in a child's life, taking 
this figure as indicating a developmental epoch, marks a 
distinct transition. 

They also admit that their examination "tends 
toward a low grading of the child," so that, even if we 
would take it for granted that these tests help in de- 
tecting mental defect, we should have to be very char- 
itable in grading results. 

On the other hand, this last admission is in contrast 
to the one quoted before (p. 263) which would indicate 
rather that the children who were taken as "normals" 
came from the less intellectual strata of Paris. 

What Is Intelligence? — The Binet Tests which corre- 
late intelligence with age are avowedly tests of "intelli- 
gence." But what is intelligence? Professor J. C. Bell 
calls the selection of the Binet Tests largely a matter 
of caprice. Intelligence may be considered as designat- 
ing that part of the mind, or soul, that knows; as differ- 



266 THE EXCEPTIONAL CHILD 

entiated from the feelings and the will. It is rather an 
ancient type of psychology which makes distinctions of 
this kind. We note that all the so-called different fac- 
ulties of the soul are intimately interrelated and de- 
pendent upon one another — that feeling enters into voli- 
tion; that volition determines knowledge, etc. Again, 
we note that the soul is not an entity but a composite, 
made up of elements, physiological, psychological, spiri- 
tual, and what not, which we are not able to define in 
their fulness. 

But in judging of a child's mind, his soul, or his status 
in society, his educational and social possibilities, we 
must certainly take into account the different functions 
of what is collectively called the "mind." There is the 
logical memory as against rote memory; there is atten- 
tion, and concentration, imagination, association, and 
reasoning; there is the faculty of initiative, of self- 
assertion, self-direction, and self-criticism. There is the 
sense of self as against the social sense and the social 
attitude. There are the different psychoses and those 
mental states that are conditioned by physical causes 
of various kinds. There are the different levels of cul- 
ture. The laborer level and the professional level rep- 
resent two distinctly different types of mind, and there 
are many other types of mind, as has been shown in 
other places in this book. 

Reference may be made once more to the statement 
of Doctor Tredgold mentioned in a previous chapter 
("The Feeble-minded Group," p. 161) that the real dif- 
ference between the feeble-minded and the potentially 
normal child is the presence or absence of "common 
sense." If that is lacking, its want can never be sup- 
plied. What we need, then, is tests which will deter- 



THE BINET SCALE OF INTELLIGENCE 267 

mine this one thing: Has the child sufficient common 
sense to be able to lead an independent existence? No 
mechanical computation of any kind of tests will help 
matters very much. The common sense of the examiner 
must strike the spark of common sense in the subject ex- 
amined. 

"Common sense," as has been shown on page 183, is 
only another expression for the intellectual aspect of 
efficiency. The author may be permitted to repeat 
here what he considers the main criterion of difference 
between the feeble-minded and the potentially normal 
— a difference which the tests must assist in discovering 
— viz., that an ament can only acquire skill, even though 
eventually reaching a high performance level; a normal 
person may never develop much skill and may remain 
forever on a low performance level, but he possesses 
efficiency, which lifts him upon the plane of human 
fellowship. 



CHAPTER XV 
THE MEANING OF AN EDUCATIONAL CLINIC 

Various Kinds of Clinics. — For the work here pro- 
posed the term "educational clinic" is suggested by the 
author. The reasons for choosing this term are as 
follows: 

We have been hearing a great deal lately of clinical 
work done for children in connection with the psycho- 
logic departments of universities. Medical schools and 
hospitals have established clinics for the examination 
of children, and have extended their work so that their 
examinations included mental tests, so-called, as the 
special function of the pediatrist, or the neurologist. 
There are also psychopathic clinics which have been 
opened for work with children presenting difficulties and 
being suspected of mental defect. When the mental 
testing of school children began to be introduced into 
organized school systems, like those of the larger cities 
of this country, they were thought to require the ser- 
vices of a trained psychologist or medical man. In the 
unformed state which characterizes the initial stages of 
any work of this nature, much confusion has necessarily 
arisen as to the functions and limitations of the various 
types of research agencies, clinical provisions, and types 
of investigators required. 

The author's views differ in a measure from those of 
others working in this field. It would seem to him that 
a distinction must be made between the different kinds 
of investigations and their purposes. 

268 



THE MEANING OF AN EDUCATIONAL CLINIC 269 

Genetic Psychology and Child Study. — It will be 
cheerfully admitted that the workings of the mind of the 
growing child have become better understood through 
what has been called "genetic psychology." There is 
no question about the psychologic aspect of the child 
problem and about the need of co-operation of trained 
psychologists, especially experimental psychologists. 
This, however, does not mean that the clinical work 
must be exclusively psychologic. Child study in its 
broader aspect goes beyond mere psychology. Child 
study has been helpful in showing the intimate relation- 
ship between bodily and mental states. The old prov- 
erb, "Mens sana in corpore sano" has assumed increasing 
significance with the revelations which have come to us 
through medical inspection of school children. It has been 
truly said that the child must be taken as a whole, as 
a body no less than as a mind, in order to receive his 
full understanding during the time of growth. Mental 
growth, spiritual growth, and emotional growth are par- 
alleled and conditioned in a measure by body growth. 
But it would be erroneous to draw from this the con- 
clusion that the medical side of a child's problem is the 
only or the determining factor of his growth. 

The Psychological Clinic. — A "psychological clinic" 
(so far as it pertains to the child problem), especially 
one which is connected with a university, has its dis- 
tinct function, or functions. 

One of these functions is to assist students in acquir- 
ing a practical understanding of child nature and of a 
child's mental growth. For this purpose a certain 
amount of actual child material will have to be worked 
with. The children thus examined represent, however, 
merely study types. They are being tested not so much 



270 THE EXCEPTIONAL CHILD 

for their own benefit as for the benefit of those who 
should learn from them, although naturally they may 
be helped individually if the results of the study lead 
to action in their behalf. It will suggest itself that the 
head of the department would carefully select children 
with whose types he wishes to familiarize his students, 
as the work will necessarily be in the nature of a dem- 
onstration. In a way, this work may be likened to the 
work in medical clinics and dispensaries where the stu- 
dents are invited to observe typical treatments and 
operations to familiarize them with the details of such 
work. For practical experience they may also be given 
certain cases to work upon under the supervision of 
their teachers. 

The author is, of course, well aware of the fact that 
dispensaries, clinics, and hospitals are used by the medi- 
cal men also for postgraduate work and for further 
study. In the same manner the expert psychologist 
may wish to enlarge the functions of the psychologic 
clinic of a university so as to include a number of cases 
which would afford him possibilities of further research 
work. For the medical man these possibilities are not 
all directly connected with the medical college, but are 
found in the numerous private institutions for the relief 
of disease, the hospitals and dispensaries. Likewise 
university psychologists may find their field for further 
investigations on a larger scale in connection with edu- 
cational clinics, which should be established in connec- 
tion with public and private school systems. 

The second distinct function of a psychological clinic, 
as it appeals to the author, is to conduct investigations 
along specific lines. This would entail intensive work 
on selected, definite psychological problems with a great 



THE MEANING OF AN EDUCATIONAL CLINIC 271 

number of individuals, adults and children, normals 
and exceptions. In this manner, various kinds of tests 
may be evolved for the testing of specific capacities and 
conditions in child growth. Standards may be estab- 
lished, meeting definite limitations, and a routine of 
practice can be developed. From these investigations 
the practical work of the educational clinic, as well as 
the routine work of the psychologic clinic will profit. 
In the author's own schedule of educational tests, a 
number of such data have been included. Mention may 
be made here of the illusion tests, the completion test, 
the picture-arrangement test, the form-board tests, etc. 

In institutions organized for the special treatment of 
certain psychic defects, this psychologic research work 
may be done particularly well and profitably. Refer- 
ence should be made to the excellent work which has 
been done in institutions for the feeble-minded and 
epileptic, as, for instance, at Waverly, Mass.; Fari- 
bault, Minn.; Vineland, N. J.; Columbus, Ohio; Skill- 
man, N. J., and Sonyea, N. Y.; also in connection with 
juvenile courts, as in Chicago, New York, etc. 

The Psychopathic Clinic. — Here, however, we are re- 
minded of another aspect of research and clinic work. 
The distinct difference between the feeble-minded and 
the psychopathic type has been repeatedly pointed out. 
Neuroses and psychoses must be differentiated from im- 
becility and moronism. Here we find the need of a 
psychopathic clinic for children. This is medical work 
of a highly specialized kind. Neurologists and psychia- 
trists will have to do this work under conditions to be 
determined by them. In fact, the number of children 
suffering from some nervous or psychic disorder is much 
larger than is generally assumed. 



272 THE EXCEPTIONAL CHILD 

It will therefore be of the greatest consequence that 
there be psychopathic clinics and laboratories to which 
children presenting danger-signals along this line of ob- 
servation can be referred. However, this does not imply 
that a psychopathic clinic can take the place of an edu- 
cational clinic. 

Medical Clinics. — Likewise medical clinics of different 
kinds, in departments for children's diseases, in chil- 
dren's hospitals, dispensaries, and similar institutions; 
dental clinics; eye, ear, nose, and throat work; ortho- 
pedic clinics; tuberculosis clinics, and pathological lab- 
oratories for the making of blood tests, serum tests, etc. 
—will be so many helpful agencies in securing a com- 
plete and correct diagnosis of a child's case. 

The work of medical inspection will suggest many op- 
portunities for the development of such clinical work 
in schools. 

But a medical clinic cannot take the place of an edu- 
cational clinic. 

Sociological and Ethnological Research.— Many symp- 
toms of a child's case may point to causes of his difficulty 
which are neither psychologic nor medical. The condi- 
tions of his home, his companionship, his environment 
in general, the social conditions determining the char- 
acter of his life experiences; the elements of heredity 
and of family history; of race and color; of immigration 
and citizenship, and many other factors go far to affect 
and direct a child's career, often more decisively than 
his physical or mental health and disease. We may 
therefore also think of sociological research work as 
well as of the studies of the ethnologist in connec- 
tion with diagnosing the puzzling case of a particular 
child. 



THE MEANING OF AN EDUCATIONAL CLINIC 273 

The Educational Clinic. — But it would seem that the 
central guiding thought is the solution of the problem 
of what can be done educationally for a given individual 
child. That would seem to be the reason why the edu- 
cational aspect must be the determining factor in this 
work. The educational view-point, the educational out- 
look, and the educational process are of the greatest 
concern. The purpose should not be, in dealing with 
an individual case, to arrive at statistical facts, or to 
fit the child into a general scheme, but to discover what 
we can do for that child. 

The educational clinic is for the individual child and 
his problem. 

The ultimate purpose of all educational investigation and 
measurement in a city school system should be to increase the 
effectiveness of the instruction which each child is to receive. 
Every educational agency, i. e., every supervisor, every special 
teacher, every regular teacher, every school building, all text- 
books, all educational equipment of whatever kind, in fact 
everything within the public school system, is fundamentally 
for providing the instruction which the child needs to make him 
individually and socially efficient. (The italics are the author's.) 1 

This clipping states the case of the educational clinic 
from the point of view of its practical usefulness. 

It should be presided over by an expert educator, who 
has not only the technical, scientific training for his pro- 
fession, but also a deep sympathy with child nature; 
one who can read a child's soul, who can win the con- 
fidence of the child, who believes in the child. He must 

1 From a paper read before the American Association for the Advance- 
ment of Science, December 30, 1914, on "The Function of a Depart- 
ment of Educational Investigation and Measurement in a City School 
System," by Frank W. Ballou, Boston. 



274 THE EXCEPTIONAL CHILD 

have psychological training in order to understand the 
genetic problems of the child mind. He ought to have 
had some training in the medical aspect of his problem, 
so as to gain at least the medical point of view. He 
should have had enough training in both these sciences 
to know his limitations, to comprehend when to call 
upon the professional psychologist and medical man (or 
woman) for advice and co-operation. It is only through 
superficial knowledge of any science that a man is 
tempted to dabble in everything. But be it understood, 
at the head of an educational clinic must be an educator, 
not a psychologist or a physician. 

The educational clinic should be in direct touch with 
the medical inspection work of the school system. 
There should be co-ordination of effort. Its chief should 
know Jww to correlate his work with the progress of psy- 
chology and medicine, especially of psychopathy, and 
how to co-operate professionally with the leading men 
of these professions. 

Another aspect of this work is this: In order to do the 
best work for the greatest number of children we must 
arrange matters so that we can reach out, in a well- 
organized plan, to as many school systems and school 
children as possible. If we had to rely upon the trained 
psychologists and medical specialists to do the practical 
clinical work, we should never reach the smaller towns 
and the rural communities. Let us not forget that the 
greatest number of school children live in the rural dis- 
tricts. Under present conditions they cannot receive 
the benefit of clinical work at all. 

System of Tests. — An educational clinic should ar- 
range a system of tests so simple, with an equipment 
so inexpensive, that it may be introduced even in small 



THE MEANING OF AN EDUCATIONAL CLINIC 275 

communities where the item of expense means much. 
The technic and routine should also be so simplified 
that intelligent and well-trained school superintendents, 
supervising principals, and even teachers may be found 
to be willing and capable of receiving special training 
in conducting their local educational clinics. Naturally 
the results of their testing can be only tentative, but it 
will help them to differentiate between children of dif- 
ferent types, and to make them desirous of referring 
cases to psychological and medical experts and clinics 
for further advice. 

Network of Clinics. — An educational clinic, as the 
author conceives it, is not in competition with any 
psychological, psychopathic, or general medical clinic. 
Quite the contrary. It may be considered a feeder of 
the others, since only a small percentage of children will 
need a special psychological or psychopathic examina- 
tion, or special medical treatment of the kind that has 
to be given by experts. We may think of an arrange- 
ment which would provide for half a hundred or more 
educational clinics to one of the others. It is, of course, 
understood that the educational clinic of any school 
system, large or small, would be in constant touch with 
the medical inspector of the district. It will also be 
found that the medical fraternity in every place will be 
quite ready to co-operate. 

Educational clinics may also be organized for systems 
of private schools; in connection with social centres not 
otherwise provided for; and with children's and juvenile 
courts and detention homes, truant schools, reformatories, 
etc. The system of reference may be the same. 



CHAPTER XVI 

SCHEDULE OF TESTS 

Completer Schedule. — In the author's book, "The 
Study of Individual Children/' a full description is 
given of the schedule of tests as it was developed by 
him in the school for exceptional children, Herbart Hall, 
at Plainfield, N. J. This schedule is outlined in Chap- 
ter XII of this book. In the light of later investiga- 
tions the author's practice in the educational clinics 
organized by him has been somewhat modified by omit- 
ting some of the old tests and adding new ones, and by 
substituting new tests for old ones. 

As will be remembered, the schedule employed there 
is a very extended one. To collect all the material re- 
quired for completing these tests, a long observation is 
imperative. The schedule is supplemented by studying 
the actual work of the pupils in the school, their con' 
duct in the classroom, on the playground, and in their 
companionship with others in their school home, their 
life habits, and their emotional states. 

The Briefer Schedule. — For the purpose of shorter 
clinical examinations a new schedule has been com- 
piled, much briefer and more condensed. In this way 
larger numbers of children can be reached, through the 
organization of educational clinics, in connection with 
school systems, courts, etc. 

Even this shorter schedule, however, lends itself to 

276 



SCHEDULE OF TESTS 277 

the use in connection with observation classes and 
schools, parental schools and other provisions in any 
school system for a fair observation and study of chil- 
dren. 

Care has been taken to arrange the schedule so that 
it can be inexpensively introduced into almost any 
school system, even smaller towns and rural districts. 
The equipment has been simplified in every way. As in 
the larger schedule, many of the tests can be applied 
to groups of children at a time, in the classroom, if nec- 
essary. Most of them are devised in such a manner 
that they have the character of play and from the start 
give the child the benefit of a gratification of childish 
instincts and interests. 

Still further to put the child at ease and to give him 
the feeling that he is in a pleasant environment and 
not in a "clinic," as this term is for the most part un- 
derstood, the author has taken care that the rooms 
in which he conducts his own work are attractively 
equipped. Only such apparatus is in evidence as will 
arouse the child's eager interest. The walls are deco- 
rated with silhouettes and pictures illustrating child and 
animal life, or representing fairy-tales, well-known fig- 
ures from the Mother Goose Tales, and the like. All 
this seems to be for decorative purposes only, but fur- 
nishes at the same time test material, for the identifica- 
tion of pictures, story-telling from pictures, etc. The 
whole atmosphere of the place where such investigations 
are conducted must be inviting, cheerful, playroom- 
like. 

The condensed schedule comprises four cards, using 
three different colors for ready discrimination. The 
first card, white, is a Child History card. The second, 



278 THE EXCEPTIONAL CHILD 

blue, is intended for a record of physical examinations. 
The remaining two, yellow, are reserved for the educa- 
tional tests. 

(i) Child History 

The blank card is as follows: 

EDUCATIONAL CLINIC 

No 

Referred by (Organization or person) per 

Address Date 



CHILD HISTORY 



Name of child Date of birth 

Place of birth Address 

If foreign-born, how long in this country? 

Name of father Mother 

Born when ? 

Born where ? 

Immigrated when ? 

White or colored? 

Occupation 

Health and disease 



Living or dead ? 

Cause and time of death. 



Grandparents and other relatives 

Other children (including still-births and miscarriages) . 



Order and conditions of birth. 



Diseases child has had (state date, etc.) : 

Appendix Infantile paralysis Rickets 

Bladder Inflammation of bowels Rupture 

Cerebro-spinal men- Scarlet fever. 

ingitis Inflammation of brain . . Scrofula 

Colon Smallpox 



SCHEDULE OF TESTS 279 

Convulsions Insanity St. Vitus's dance 

Diphtheria Kidneys Stomach 

Ear disease Liver Throat 

Epilepsy Measles Thyroid gland 

Eye disease.. German measles Tuberculosis 

Fevers Neuralgia Typhus 

Genitals Nose . i Varioloid 

Headaches Ophthalmia Whooping-cough 

Head eruptions Pleurisy Other diseases 

Heart Pneumonia 

Hemorrhage Rheumatism 



Other physical conditions 

Moral status 

Special characteristics and tendencies. 



Mental status 

School grade. . . .Reading Writing Number. . . 

Language Nature History Geography. 

Manual work Art 

Music School progress 

General intelligence 

Remarks 

Home conditions 

Additional information 



Reason for reporting child 

Parent's or guardian's signature 

Reported at clinic 19 . . . 



On this card the child history is considerably con- 
densed as compared with the one used with the author's 
larger system of tests. It is, however, of the greatest 
importance to obtain as much information as possible 
from parents, relatives, friends, and physicians. Much 
light is thrown upon the child's condition and its causes 
by facts about the parents and relatives, and their men- 
tal and physical health and disease. The home condi- 
tions — which affect a child's status considerably and are 



280 THE EXCEPTIONAL CHILD 

often much more powerful in their effect than alleged 
hereditary influences — require the closest scrutiny. 
School nurses, friendly visitors, social workers are among 
the agencies to give helpful reports when we come to 
cases from the slums. A good method to collect infor- 
mation is to work through parent-teachers' meetings, 
visits of teachers in the homes of their pupils, and simi- 
lar occasions. 

It is well to note which place the child occupies in the 
number of births — whether he is the first, second, third, 
etc., child. First children and last-born children are 
apt to suffer from more or less distinct handicaps. 
There are biological reasons, economic reasons, reasons 
of educational experience, effects of spoiling, etc. How 
many children are there? How many boys, how many 
girls ? Among the children born to the family, are there 
any dead? What was the cause of their death? At 
what age did they die? How did they number in the 
order of birth? Were there any still-births or miscar- 
riages? In the case of the latter, in what month of 
pregnancy? What were the possible causes? As a 
matter of fact, it is important to number still-births and 
miscarriages in the order of births, just as if they repre- 
sented children actually born. This information may 
explain why children born previous to, or after, still- 
births and miscarriages were handicapped ; the condition 
of the mother has to be carefully considered. Did the 
mother try to prevent motherhood? Was the child an 
unwelcome child ? It is, of course, hardly to be expected 
that all this information can be easily or completely 
obtained. But discreet efforts should be made to dis- 
close as many facts as possible. 

The conditions of birth should be noted. Was the 



SCHEDULE OF TESTS 281 

child born at full term ? Was birth natural or was child 
taken with instruments? What were the conditions of 
labor ? x Was the mother under physical or mental 
strain during pregnancy? Was the child nursed or 
bottle-fed ? 

The record of diseases and other physical conditions 
should be carefully made. The age, or year, when the 
child had a certain disease should be recorded. There 
is a distinct relation of some physical conditions with 
others. For instance: headaches are often caused by 
visual impairment, by nasal-pharyngeal obstruction, or 
digestive troubles. The effect of scarlet fever or measles 
is not rarely one of general lack of tone and resistance. 

Regarding the moral status of a child we may have to 
be satisfied with statements of unwarranted opinions 
unless teachers and parents have learned to interpret a 
child's conduct in terms of danger-signals. But even 
mistaken judgments of a child's conduct may well be 
recorded, as they show how a child reacts upon others. 

Similarly, the child's special characteristics and tenden- 
cies should be noted down as far as information can be 
obtained. It should be mentioned in this connection 
that a child often reacts very differently upon his school 

1 Even a very difficult birth by no means predestines a child to be- 
come handicapped in life. The great German poet, Goethe, caused his 
young mother (she was only 18 years old when she gave birth to her 
first-born, who was to become one of the greatest of the human race) 
much suffering before he saw the light. She suffered mortal agony for 
three days before the child was delivered. And the young babe looked 
so lifeless and miserable that it was thought he was still-born. For 
hours they rubbed his body with wine, until finally he opened his eyes 
and — lived. It is worthy of notice that the young mother did not have 
the assistance of an obstetric physician in her severe labor, but had to 
rely on midwife and grandmother. At that time there was no such 
person as a gynecologist or obstetrician in Frankfurt. (Case 36.) 



282 THE EXCEPTIONAL CHILD 

environment from the way he reacts upon his home 
environment. Both sides of a child's nature should 
find recognition in these statements. 

The mental status of the child should be recorded as 
impartially as possible. Space has been provided for 
statements on school progress and on general intelli- 
gence. These two are by no means always parallel. 
These points have been set forth in detail in the chapters 
of the first part of this book, so that they need no re- 
iteration here. The career of some successful school 
pupils has ended in an institution for the feeble-minded 
or in an almshouse. 

Thus, the school grade a child has reached is of rela- 
tively little significance, although it is well to have it 
on record. It is the practice in many schools which 
have no other ways of disposing of backward or non- 
conforming children, to move a pupil to the next higher 
grade after he has been in the lower for two years, even 
unsuccessfully. This is not a promotion for scholarship, 
for of scholarship there is none, but for what is reckoned 
to be age and maturity. Thus, we may find children in 
the fourth or fifth grade who are really doing the work 
of the first. From the fourth or fifth they may drop 
out, having reached the limit of school age without hav- 
ing received any school education at all. In other places 
a pupil stays in a class unpromoted year in, year out, 
no matter what his age may be. Thus we may find 
children of fourteen years in the primary grades. It is 
difficult to say which one of these two plans is the more 
vicious. On the other hand, some children may pass rap- 
idly through the grades, owing to some mechanical perfec- 
tion, without that real mental maturity which the scaling 
of every successive grade would seem to involve. The 
truly bright and talented child is often lost in the mass. 



SCHEDULE OF TESTS 283 

We can hardly expect to have anything but ordinary 
school marks on this card, in the record of the child's 
standing in the various branches of instruction. But 
even these are significant for comparison, and for sizing 
up the child's predicament. 

(2) Physical Examination 

The blank card contains the following items: 

EDUCATIONAL CLINIC 
No Date child was examined 



PHYSICAL EXAMINATIONS 

Name of child Date of birth 

Examiners 



Height standing Height sitting Weight 

Lung capacity Grip Push Vital index. 

General appearance Nutrition 

Head Cephalic index 

Eyes 

Ears 

Nose 

Mouth 

Teeth Palatal arch 

Tonsils Pharynx 

Glands 

Chest 

Lungs Von Pirquet 

Heart 

Spine 

Digestive apparatus 

Urine 

Blood Wassermann 

Genitals 

Sexual function 

Extremities 

Gait and station Prehension 

Dexterity 

Chorea Habit spasms 



284 THE EXCEPTIONAL CHILD 
Knee jerk Neuroses 



Speech 

Other findings. 



Diagnosis and suggestions . 



Room is left on this blank for entering the names and 
statements of several examiners. The height and weight 
measurements, the lung capacity, grip, and push can 
possibly be recorded in the Educational Clinic itself, as 
the obtaining of these data require little special prepara- 
tion and can be ascertained by any intelligent teacher 
with the necessary apparatus. 

The outfit for these measurements consists of a phy- 
sician's scale; a stadiometer or measuring-rod for mea- 
suring height; a spirometer for measuring the lung ca- 
pacity; a grip dynamometer, and a little instrument for 
measuring power of push. 

Whenever feasible, the measurements should be taken 
over the unclothed body, so as to allow of accuracy and 
complete observation. Wherever that is impossible, 
only a minimum of clothing should be allowed, the 
weight of which can be easily deducted. Clothing is 
usually heavier than it is supposed, and constitutes a 
source of considerable error. In measuring large num- 
bers for the purpose of obtaining mathematical means, 
this error may be minimized, through plus and minus 
cancellations; but in following up the height and weight 
of an individual child, errors of a few pounds in weight 
or of an inch in height may obscure the onset of disease. 

It is, furthermore, more important that the figures 
for height and weight should correspond with one an- 



SCHEDULE OF TESTS 285 

other than that the child be "average" in these mea- 
sures. In other words, a child may represent a smaller 
or a larger type without danger to his development, 
provided height and weight measures correspond. But 
if he should weigh less than the average boy of his age, 
yet his height be average or even above the mean for 
his age, or vice versa, there is reason to investigate. 
Excessive or distinctly stunted growth is, of course, also 
abnormal. But it has been found that in general the 
larger and taller children are more successful than the 
smaller ones. Loss of weight is a danger-signal. 

Attention is again called to the tension which may 
be caused by discrepancies between the chronological, 
anatomical, physiological, and psychological growth 
periods of a child. Stunted growth and underdeveloped 
functioning, coupled with overalert and precocious men- 
tality, will predispose a child for a collapse. There are 
also children with precocious physical growth, unaccom- 
panied by corresponding mental development, often 
being decidedly backward intellectually. Absolute nor- 
mal poise, when all the different aspects of human per- 
sonality are well related, is comparatively rare. 

The following tables, taken from Hastings' "Manual 
of Physical Measurements," with the centimetres figured 
in inches and the kilos figured in pounds, will give the 
results of measurements of many children for compari- 
son with the figures obtained for the individual child 
under observation. This table gives, in addition to the 
mean for every age, various sizes with the normal cor- 
responding weight. In the light of what has been said 
in the preceding paragraph, this table is more valuable 
than one which would only state age averages. An age 
average has little significance for the individual case. 



286 



THE EXCEPTIONAL CHILD 



HEIGHT AND WEIGHT MEASUREMENTS OF BOYS 

From Hastings' "Manual of Physical Measurements" 



Age of 5 




Age 


of 6 




"cm. 


in. 


kilo. 


lbs. 


cm. 


in. 


kilo. 


lbs. 




1 1 2 . 00 


44.01 


21 .02 


46.24 


1 1 6 . 00 


45.58 


21 .92 


48.22 




110.00 


43-23 


19.20 


42.24 


114.00 


44 


79 


20 


85 


45 87 




108.00 


42.44 


18.84 


41.44 


112 .00 


44 


01 


19 


89 


43-75 




106.00 


41.65 


18.26 


40.17 


110.00 


43 


23 


19 


49 


42.87 




104.00 


40.87 


17-50 


38.50 


108.00 


42 


44 


19 


02 


41.84 




102 .00 


40.08 


17.29 


38.03 


106.00 


4i 


65 


18 


21 


40.06 




100.00 


39-3° 


16.31 


35-88 


104.00 


40 


87 


17 


82 


39.20 




98.00 


38-51 


15-99 


35-17 


102.00 


40 


08 


16 


36 


35-99 


Mean: 


105.78 


41-75 


17.86 


39-29 


110.67 


43-49 


19-37 


42.61 




Age of 


7 




Age of 8 




122.00 


47-94 


24-51 


53-94 


127.00 


49.91 


26.93 


59-24 




120.00 


47-15 


22.78 


50.12 


125.00 


49 


12 


24.64 


54 


20 




118.00 


46.36 


22.00 


48.40 


123 .00 


48 


33 


24.47 


53 


63 




116.00 


45-58 


21.50 


47-31 


121 .00 


47 


54 


23-74 


52 


22 




114.00 


44-79 


21 .00 


46.21 


119.00 


46 


75 


22.35 


49 


17 




112.00 


44.01 


19.48 


42.86 


117.00 


45 


97 


21.77 


47 


89 




110.00 


43-23 


19-39 


42.67 


115.00 


45 


18 


21. 11 


46 


44 




108.00 


42.44 


18.38 


40.45 


113 .00 


44 


40 


19.72 


43 


38 


Mean: 


115-69 


45-46 


21.30 


46.49 


121. 31 


47.67 


23-14 


50.90 




Age of 


9 






Age c 


F IO 






132.00 


51-87 


28.36 


62.39 


136.00 


53-44 


30.82 


67.80 




130.00 


5i-o8 


27.26 


59 


97 


134.00 


52.65 


29-15 


64.13 




128.00 


50.29 


26.87 


59 


11 


132 .00 


51-87 


28.14 


61 .90 




126.00 


49-51 


25-54 


56 


18 


130.00 


5i-o8 


27.53 


60.56 




124.00 


48.72 


24.70 


54 


34 


128.00 


50.29 


26.27 


57-79 




122.00 


47-94 


24.07 


52 


95 


126.00 


49-51 


25.78 


56.71 




120.00 


47-15 


22.72 


49 


98 


124.00 


48.72 


24.90 


5478 




118.00 


46.36 


21.49 


47 


27 


1 2 2 . 00 


47-94 


24.OI 


52.82 


Mean: 


125.86 


49-56 


25.07 


55-15 


130.95 


51.46 


2785 


61.27 




Age of 


11 






Age c 


F 12 






142.00 


55-8o 


34-78 


87.51 


146.00 


57-73 


37.56 


82.63 




140.00 


55-OI 


32.40 


71.28 


144.00 


56.58 


35-74 


78.62 




138.00 


54.22 


31-08 


68.37 


142.00 


55.8o 


34-54 


75-98 




136.00 


53-44 


30.29 


66.63 


140.00 


55-oi 


34-04 


74-88 




134.00 


52.65 


29-51 


64.92 


138.00 


54-22 


33-27 


73 19 




132 .00 


51.87 


27-73 


61 .00 


136.00 


53-44 


30.68 


67.49 




130.00 


5i-o8 


28.52 


62.74 


134.00 


52.65 


30.39 


66.85 




128.00 


50.29 


25-88 


56.93 


132.00 


51.87 


28.44 


62.56 


Mean: 


134-90 


53-OI 


29.86 


65.69 


140.29 


55-13 


32.98 


72.55 



SCHEDULE OF TESTS 



287 



Age of 13 


Age of 14 


cm. 


in. 


kilo. 


lbs. 


cm. 


in. 


kilo. 


lbs. 


154.00 
151.00 
148 . 00 
145-00 
142.00 
13900 
136.00 
133 00 


60.51 
59-33 
58-15 
56.98 
55-8o 
54.62 

53-44 
52.26 


43-98 
39.62 
38.18 
36.06 
35-3Q 
33-66 
31-82 
29.09 


96.75 
87.16 
83-99 
79-33 
77.66 
74-Q5 
70.00 
63-99 


164.00 
160.00 
156.00 
152.00 
148.00 
144.00 
140.00 
136.00 


64 
62 
61 
59 
58 
56 
55 
53 


4S 
87 
30 
73 
15 
59 
01 
44 


54-77 
48.50 
45 -50 
42-33 
39 46 
36.85 
34-74 
30.76 


120.49 
106.70 
100. 10 
93-12 
86.81 
81.07 
76.42 
67.67 


Mean: 145.09 


57.02 


35- 60 


78.32 


151-02 


59-34 


39-73 


87.40 


Age of 15 


Age of 16 


170.00 
166.00 
162.00 
158.00 
154.00 
150.00 
146.00 
142 .00 


66.81 
65-23 
63.66 
62.08 
60.51 
58.95 
57-37 
55-8o 


60 
54 
52 
48 
44 
4i 
38 
35 


45 
43 
95 
98 
54 
59 
68 
68 


132 

119 
116 
107 
97 
9i 
85 
78 


99 
74 
49 
75 
98 
49 
09 
49 


173-00 
170.00 
1 67 . 00 
164.00 
161 .00 
158.00 
15500 
152.00 


67.98 
66.81 
65-63 
64-45 
63.27 
62.09 
60.91 
59-73 


64.09 
58.07 
56.36 
55-oo 
52.88 
47.12 
44.09 
40.00 


140.99 
127.75 
123.99 
121 .00 
116.33 
103.66 
96.99 
88.00 


Mean: 158.18 


62.16 


46.95 


103.29 


163.73 


64-34 


52.90 


116.38 


Age of 17 


Age of 18 


178.00 
175.00 
172.00 
169.00 
166.00 
163.00 
160.00 
15700 


69-95 
68.77 
67-59 
66.41 
65-23 
64.04 
62.87 
61 .96 


63.56 
62.39 
58.64 
57-14 
55-97 
53-18 
49.88 
45-45 


139 
137 
129 
125 
123 
116 
109 
99 


83 
25 

00 
70 
13 
99 
73 
99 


180.00 
177.00 
174.00 
1 7 1 . 00 
168.00 
165.00 
162.00 
159.00 


70.72 
69-54 
68.36 
67.20 
66.02 
64.83 
63.66 
62.47 


66.27 
64.32 
62.73 
60.78 
57-27 
54-24 
54-36 
53-13 


145-79 
141.50 
138.00 
133-71 
125-99 
119.32 
"9-59 
116.88 


Mean: 169.98 


66.80 


56.82 


125 .00 


171 .07 


67.23 


59-25 


130.35 


Age. of 19 


Age of 20 


182.00 
179.00 
176.00 
173-00 
170.00 
167.00 
164.00 
161 .00 


71-52 
70.34 
69.16 
67.98 
66.81 
65-63 
64-45 
63.27 


67.61 
65.11 
64.09 
61.93 
60.60 
58.91 
56.95 
52.67 


148.74 
143-24 
140.99 
136.22 
133-32 
129.60 
125.29 
115.87 


184.00 
181 .00 
178.00 
175.00 
172.00 
169.00 
166.00 
163.00 


72.30 
71 .12 
69-95 
68.77 
67-59 
66.41 
65-23 
64.04 


74-77 
66.93 
65.18 
63.68 
60.45 
59-32 
59-14 
54-59 


164.49 
147.24 
143-39 
140.09 
132.99 
130.52 
130.10 
1 20 . 09 


Mean: 171.89 


67.52 


61.71 


135-76 


172 .22 


67.67 


61 .09 


134-39 



288 



THE EXCEPTIONAL CHILD 



HEIGHT AND WEIGHT MEASUREMENTS OF GIRLS 

From Hastings' "Manual of Physical Measurements" 







AGE OF 


5 






Age 


OF 6 




cm. 


in. 


kilo. 


lbs. 


cm. 


in. 


kilo. 


lbs. 




1 1 2 . oo 


44.01 


20.74 


45.62 


116.00 


45-58 


21.36 


46.99 




IIO.OO 


43-23 


18.71 


41 


16 


114.00 


44 


79 


20.20 


44-44 




108.00 


42.44 


18.86 


41 


49 


112 .00 


44 


01 


19.64 


43.20 




106.00 


41-65 


18.22 


40 


08 


110.00 


43 


23 


19.01 


41.82 




104.00 


40.87 


17.27 


37 


99 


108.00 


42 


44 


18.28 


40. 21 




102.00 


40.08 


16.84 


37 


04 


106.00 


4i 


65. 


17.73 


39.00 




100.00 


39 -30 


16.02 


35 


24 


104.00 


40 


87 


16.93 


37-24 




98.00 


38.51 


15-23 


33 


50 


102.00 


40 


08 


16.31 


35-88 


Mean: 


105-38 


41.41 


17-32 


38.10 


109.90 


43 19 


18.50 


40.70 






Age op 


7 






Age 


3F 8 






121.00 


47-54 


23-04 


50.68 


126.00 


49 51 


25-53 


56.16 




119.00 


46 


75 


22.44 


49 36 


124.00 


48 


72 


23.98 


52.75 




1 1 7 . 00 


45 


97 


20.78 
20.70 


45-71 


122.00 


47 


94 


23.24 


51.12 




115.00 


45 


18 


45-67 


120.00 


47 


15 


22.18 


48.79 




113.00 


44 


40 


20. 10 


44.22 


118.00 


46 


36 


21.49 


47.27 




in .00 


43 


61 


19.65 


43-23 


116.00 


45 


58 


20.85 


45.87 




109 . 00 


42 


82 


18.42 


40.52 


114.00 


44 


79 


20.23 


44-So 




107.00 


42 


04 


17.38 


38.23 


112 .00 


44 


01 


18.90 


41-58 


Mean: 


H495 


45-17 


20.70 


45-54 


120. 16 


47.22 


22. 17 


48.77 






\ge of 


I 






Age c 


F IO 






132.00 


51.87 


28.61 


62.94 


136.00 


53-44 


3I-40 


69.08 




130.00 


51.08 


27.06 


59-53 


134.00 


52 


65 


29. 20 


64 


24 




128.00 


50.29 


25.90 


56.98 


132.00 


51 


87 


28.I4 


61 


90 




126.00 


4Q-5I 


25-33 


55-72 


130.00 


51 


08 


26.59 


58 


49 




1 24 . 00 


48.72 


23.85 


52-47 


128.00 


50 


29 


26.31 


57 


88 




1 2 2 . 00 


47-94 


23-35 


51-37 


126.00 


49 


5i 


25-32 


55 


70 




120.00 


47 15 


22 .76 


50.07 


124.00 


48 


72 


24.24 


53 


32 




1 1 8 . 00 


46.36 


21-34 


46.94 


122.00 


47 


94 


22.70 


49 


94 


Mean: 


126. 17 


49-59 


24.90 


54-78 


131.29 


51-59 


27. 16 


5975 




. J 


lGE OF 1 


1 






Age c 


F 12 






142 .00 


55-80 


34-03 


74.86 


152.00 


59-73 


42.36 


93 19 




140.00 


55 


01 


31.82 


70.00 


1 49 . 00 


58 


55 


38.86 


85-49 




138.00 


54 


22 


31-25 


68.75 


146.00 


57 


37 


36.93 


81.24 




136.00 


53 


44 


30.27 


66.59 


143.00 


56 


19 


34-85 


76.67 




134.00 


52 


65 


28.35 


62.37 


140.00 


55 


01 


32.62 


71.76 




132.00 


5i 


87 


28.07 


6i.75 


137.00 


53 


83 


30.80 


67.76 




130.00 


.51 


08 


27-73 


61 .00 


134-00 


52 


65 


29.58 


65.07 




128.00 


50 


29 


24-73 


54-40 


131.00 


51 


47 


27.50 


60.50 


Mean: 


135-1° 


53-12 


29.00 


63.80 


142.03 


55.8i 


33 06 


72.73 



SCHEDULE OF TESTS 



289 



Age of i 


3 




Age of 14 


cm. in. 


kilo. 


lbs. 


cm. 


in. 


kilo. 


lbs. 


156.00 


61.30 


45-91 


101.00 


164.00 


64-45 


51-27 


112.79 


15300 


60. 12 


42-73 


94 


00 


161 .00 


63.27 


48.89 


107.55 


150.00 


58.95 


40.26 


88 


57 


158.00 


62.09 


45-91 


101 .00 


147.00 


57-77 


38.41 


84 


50 


i55-oo 


60.91 


45 -98 


101.15 


144.00 


56.59 


35-05 


77 


11 


152.00 


59-73 


43 13 


94.88 


141 .00 


55-41 


34-09 


74 


99 


149.00 


58.85 


41.42 


91 . 12 


138.00 


54-23 


3i-i4 


68 


46 


146.00 


57-37 


38.07 


83.75 


13500 


53 05 


29-54 


64 


98 


143.00 


56.19 


35-05 


77.11 


Mean: 148.53 


58.35 


37-94 


83.46 


I53-I7 


60. 19 


42.92 


94.42 


Age of i 


5 




Age of 16 


162.00 


63.66 


53- 18 


116.99 


1 64 . 00 


64.44 54-48 


119-85 


160.00 


62.87 


40 


45 


108.79 


162 .00 


63-66 52.36 


115-19 


158.00 


62.08 


48 


49 


106.67 


160.00 


62.87 


53-50 


II7.7O 


156.00 


61.30 


47 


OS 


103.51 


158.00 


62.08 


50.40 


IIO.88 


154.00 


60.51 


45 


34 


99-74 


156.00 


61.30 


50.00 


IIO.OO 


152.00 


59-73 


45 


00 


99.00 


154.00 


60.51 


49.09 


IO7.99 


150.00 


58.94 


44 


09 


96.99 


152.00 


59-73 


46.82 


IO3 .OO 


148.00 


58.15 


40 


60 


89.32 


1 50 . 00 


58.94 


45-55 


IOO. II 


Mean: 156.79 


61.61 


46.71 


102.76 


157-93 


62.00 


50.38 


IIO.83 


Age of ] 


7 




Age of 18 


165 .00 


64.83 


57-95 


127.49 


166.00 


65-23 


55-45 


1 2 1 . 99 


163.00 


64.04 


53-64 


118.00 


164.00 


64.44 


53.i8 


1 1 6 . 99 


161 .00 


63.26 


50.15 


110.30 


162.00 


63.66 


51.06 


112.33 


159.00 


62.47 


49 -85 


109.67 


1 60 . 00 


62.87 


50.85 


in. 87 


157.00 


61 .96 


50.45 


110.99 


158.00 


62.08 


48.96 


107.71 


i55-oo 


60.90 


48.49 


106.67 


156.00 


61.30 


48.82 


107.40 


i53-oo 


60. 11 


50.23 


110.50 


154.00 


60.51 


47.84 


105.24 


151.00 


59-33 


48.49 


106.67 


152.00 


59-73 


46.70 


102.74 


Mean: 159.40 


62.63 


50.44 


110.96 


159-74 


62.77 


50.16 


110.35 


Age of i 


9 






Age of 20 




166.00 


65-23 


55- 60 


122.32 


1 66 . 00 


65-23 


56.99 


125-37 


164.00 


64.44 


55-91 


123.00 


164.00 


64-44 


53-64 


1 1 8 . 00 


162 .00 


63.66 


54-09 


118.99 


162 .00 


63.66 


52.05 


114. 51 


160.00 


62.87 


50.91 


112.00 


1 60 . 00 


62.87 


51.82 


114.00 


158.00 


62.08 


50.45 


110.99 


158.00 


62.08 


5188 


114. 13 


156.00 


61.30 


50.09 


no. 19 


156.00 


61.30 


5I.I4 


112.50 


154.00 


60.51 


46.14 


101.50 


154.00 


60.51 


50.45 


110.99 


152.00 


59-73 


44-85 


98.67 


152.00 


59-73 


45.00 


99.00 


Mean: 160.09 


62.90 


51-43 


113. 14 


160.81 


63.19 


52.27 


114.99 



290 THE EXCEPTIONAL CHILD 

Lung capacity is often called vital capacity. 1 There is 
a distinct relation of vital capacity to weight. This 
relation is determined by dividing the vital capacity in 
cubic centimetres by the weight in kilograms. The 
ratio thus obtained shows whether the child's lung ca- 
pacity is normal for his weight. It is called the Vital 
Index. Kotelmann has computed the normal vital index 
for the different ages (largely using age means, however). 
His table is as follows: 



Age 9 10 ii 12 13 14 

Index 69.32 69.37 69.18 67.51 66.75 64.07 

Age 15 16 17 18 19 20 

Index 63.18 65.94 65.77 64.28 66.22 65.01 



Professor Pyle has taken Smedley's norms of weight 
and vital capacity and computed the vital index in 
terms of the number of cubic centimetres of air capacity 
per pound of weight, by converting the weight in kilo- 
grams to pounds and dividing this weight in pounds 
into the vital capacity. "It will be noticed," he says, 
"that the girls show a falling off after the age of 11. 
This may be due to tight lacing." This is his table: 



Age.... 


6 


7 


8 


9 


10 


11 


12 


13 


14 


15 


16 


17 


18 


Boys. . . 


• 23 


24 


25 


25 


25 


25 


25 


25 


25 


25 


26 


27 


27 


Girls . . . 


22 


23 


23 


23 


23 


23 


22 


21 


20 


20 


20 


20 


20 



1 Cf. "Lung Capacity of Children." Spirometer Tests of 1,618 White 
School Children (751 Boys, 876 Girls) in the City of X. By C. W. 
Stiles and Floyd Graves. Published by the United States Public Health 
Service, Washington, D. C, October 15, 1915. The investigations of 
these two authors show a distinct difference in the development of the 
lung capacity of boys and girls of different ages. 



SCHEDULE OF TESTS 291 

In some cases the medical inspector may enter the 
result of a general physical examination first. His find- 
ings, or his observations made during the clinical tests, 
may suggest that the child be referred to specialists for 
more thorough examinations of vision, hearing, and 
other vital functions, including blood tests, etc. These 
should also be entered on this card. 

Many schools have already established clinics in con- 
nection with their medical inspection work. It may be 
well to have a pathological laboratory within reach for 
the ready examination of the sputum, urine, faeces, and 
blood, and for the eventual application of the von 
Pirquet and Wassermann tests. 

Much might be said here about the great importance 
of the development of the sexual function and of an 
examination of the genitals in cases where there seem 
to be mental, moral, and emotional disturbances. But 
reference to remarks in previous chapters, and in the 
"Medical Symposium" of this book will suffice. 



(3) Educational Tests 

The material for the educational tests is spread over 
two cards. 

EDUCATIONAL CLINIC 

Educational Tests 

No Name Date 



(A) Visual: 

* 1 . Distance 

* 2. Colors: (a) Matching O = (b) Naming 

f 3. Memory: (a) colors; (6) . . . .objects; (c) words 



292 THE EXCEPTIONAL CHILD 

(B) Auditory: 

* i. Distance O 2. Location 

3. Character 0*4. Pitch 

f 5. Memory: (a) Single tone (6) words 

(c) Word-Picture : Primary images 

Elementary images 

Intermediate images 

Advanced images 

(C) Tactile: 

* f 1. Objects, large 

* O t 2. Objects, small 

= 3. Geometric forms 

* 4. Needle-points 

(D) Smell: (* t) 

(E) Taste: (* O f) 

(F) Motor Co-ordination: (*) Threading needles 

(G) Location: (* 0) (H) *Balance: 

(/) Train of Ideas: (f 0) Hammer 



Book. 



Mother 

(/) Imitation: (f) 1. Movement 

2. Knox Test 

3. Peg-board 

(K) Concentration: (f) 1. Following directions ( errors) 

2. Remembers momentarily exposed objects. 

3. 100 A's, . . .% Time 

(L) Naming of Objects: (O) i. In room 

2. In pictures 

(M) Language: 

0=i. Tells story from pictures 

= 2. Writes reproduction of story told him 

Writes reproduction of story read by him 

Writes reproduction of story from memory 

f = 3. Completion test (Thorndike) out of 56 sentences. 

O f 4. Ciphers. First order {rearrangement) 

Second order (numbers or letters) 

Third order (symbols) 

O * = 5. Opposites: out of 40 given words 

O * = 6. Classification. 1. Qualities out of 21. 

2. Activities out of 22. 3. Categories 

out of 15 (first set); out of 

15 (second set). 



SCHEDULE OF TESTS 293 

(N) Reading: (* f = ) i. Grade 2. Facility 

3. Expression 4. Enunciation 

5. Understanding 

(0) Writing: (* 1 =) 1. Own name 2. Copy from 

Reader. 3. Dictation (Spelling) 

4. Composition 

(P) Number Concept: (* =) 1. Counting: (a) Counts to 

(b) Counts backward 10 to 1 ; 100 to 1 ; (c) Counts 

by twos to ; (d) Backward by twos, 10 to 2 ; 20 to 2 

; (e) By tens to ; (/) Backward by tens, 100 to 10 

; 1,000 to 10 ; (g) By fives to ; (A) Backward 

by fives, 25 to 5 ; 100 to 5 ; (i) By threes to ; 

(j) Backward by threes, 1 2 to 3 ; 99 to 3 ; {k) Con- 
structing numbers on abacus ; (/) Adding with dice ; 

(m) Adding and subtracting game 

* f 2. Comparing unequal heaps of sticks 

* t 3- Comparing sticks of different lengths 

= 4. Courtis tests 

O f 5. Problem in judgment 

f 6. Magic square * = 7. Doyle test 

(Q) Discrimination : (f) 1. Matching pictures 

2. Resisting suggestion in comparing lines (Binet) 

3. Picture arrangement (Fraser) 

4. Illusions, (a) Weights (b) Optical 

(22) Construction: (* f 0) 

1. Form-boards: 

(a) Seguin's Method Time 

(b) Healy's 1 Method Time 

2 Method Time 

3 Method Time 

4 Method Time 

5 Method Time 

2. Reconstructs pictures, No. of pieces Time 

Method 

Cubes Time 

Method 

3. 100 Dots Method Time 

4. Color cubes, copy design Method Time 

Original design Method Time 

5. Anchor puzzle Method Time 

6. Building blocks: (a) Steps (b) Bridge (c) House.. . 

Method Time 

7. Construction of houses : 1 2 3 

Method Time 

8. Mechanical construction 



294 THE EXCEPTIONAL CHILD 

(5) Expression: (f O —) i. Draws through ground glass 

2. Draws man Horse House 

3. Draws pond with trees on opposite sides 

4. Draws illustration for story 

5. Paints objects, (a) From model (6) Memory. . , 

6. Paints landscape or still-life composition 

7. Models apple Vase Statuette , 

8. Sings 9. Recites 



SUMMARY 

i. Response (prompt, slow, halting, eager, indifferent, timid, sullen) .... 

2. Fatigue 3. Effect of school training 

4. Extent of individual experience 

5. Period of development: 1. Infancy 2. Primary 

3. Elementary 4. Intermediate 

5. Advanced 

6. Type (active, aggressive, inventive, passive, retiring, imitative, 

graphic, artistic, motor, constructive, scientific, mathematical, 
linguistic, literary, sensory, commercial, domestic, progressive, 
primitive, precocious, mediocre, psychopathic, backward, defec- 
tive, mixed) 

7. Educational status 

8. Suggestions for development and vocational guidance 



Remark: A tentative distinction between tests of physiologic (*) and 
psychologic (f) function, individual experience (0) and effect of 
school training ( = ) has been suggested. 

Tests printed in italics represent minimum requirements. 

In these tests a tentative distinction has been made 
between tests of physiologic and psychologic function, of 
individual experience, and of the effect of school training. 
They are marked as indicated on the cards. Most tests 
represent, of course, a combination of these elements, 
but it has been thought helpful to the examiner to sug- 
gest these distinctions for the purpose of classifying his 
impressions. 

It is unnecessary to discourse on the meaning of 



SCHEDULE OF TESTS 295 

physiologic and psychologic function. Individual ex- 
perience is based upon native endowments and upon 
opportunities of environment. A bright child will ob- 
serve and experience more than a dull child, and favor- 
able or unfavorable home conditions — life in centres of 
civilization, or in the country; travel, companionship, 
and many other elements — will determine in a large 
measure the length of the radius of the circle which is 
covered by individual experience. Again, the effect of 
school training will depend upon the length and regu- 
larity of attendance, upon the personal influences of 
teachers and schoolmates, and upon the kind and char- 
acter of the school the child has attended. 

Some of these data will be obtained from the Child 
History information, and in a measure from the physical 
information. But much can be gained from a careful 
valuation of the response of the child to the tests them- 
selves. In the final summary, a succinct statement of 
these facts should be given. 

A. Visual Tests. — It is of the utmost importance, in 
testing a child, first to make absolutely sure that he is 
in full possession of his sense-perceptions, that his sense- 
organs function rightly. Deficiencies or irregularities in 
this field deprive the individual of the opportunity to 
gather accurate impressions of the outside world, and 
to learn from these experiences as they are mediated 
through the senses. As a matter of fact, our knowledge 
and our mental operations are bound up with sense- 
impressions, and are dependent upon them. ''Nihil est 
in intellectu quid non fuerit in sensu." 

That school progress is closely interrelated with clear 
sense-perception needs hardly to be discussed. Be the 
instruction oral or from text-books, it can reach the 



296 THE EXCEPTIONAL CHILD 

mind only through the sense-channel. Even the value 
of any mental tests, be they what they may, becomes 
doubtful unless the examiner first convinces himself 
that the child can see the things he is being tested with; 
can hear distinctly and with understanding what the 
examiner says, and has sufficiently accurate percepts 
otherwise of the subjects comprised in the examination. 
If such preliminary tests are not made, the examiner 
lays himself open to grave errors in diagnosis. 

The blind child, also the child whose vision is merely 
impaired, cannot possibly receive the benefit of visual 
object-teaching, of pictures, or of the printed page. In 
the present time, visual impressions comprise the vast 
majority of all mental stimuli, and they are far more 
varied than any other sense-impressions. 

The visualization of problems, quite apart from the per- 
ception of objects and their qualities, is a mental element 
of no mean importance. Judgment will depend in a large 
measure upon the power of visualization. (Cf. p. 126.) 
It enables the individual to grasp a situation, to get the 
perspective of things, to choose his path. Take, for in- 
stance, a test in this series, under P, 5, "Problem in 
Judgment." The problem the author uses is the follow 
ing: Imagine a short line of boys, or soldiers, marching 
in single file. Two are marching in front of one; two are 
marching behind one, and one is in the middle. How 
many boys (or soldiers) ? Unless the child visualizes 
the situation accurately, he will fail to find the right 
answer: Three. 

It will be seen that a majority of all tests require 
accuracy of vision as a "conditio sine qua non." The 
threading of needles, the imitation and concentration 
tests, the discrimination tests, the form-board tests, etc., 



SCHEDULE OF TESTS 



297 



all presuppose the child's ability to see normally, as a 
condition to perform something which may give the 
examiner information about other faculties. 

In the educational clinic, sense tests can be made only 
in the rough, so to speak. 
It is not the function of an 
educational clinic to trans- 
gress into the field of exact 
physiological and medical 
measurement and diagno- 
sis. But it can and must 
ascertain the general fac- 
ulty of sense-perception and 
discrimination, and detect 
danger-signals. The edu- 
cational clinic will instantly 
refer the child to the medi- 
cal specialist, who will ex- 
amine the child with ref- 
erence to the suspected 
defects, and only after his 
diagnosis is made and re- 
corded should the educa- 
tional examination proceed. 

Distance Tests. — In the 
distance tests the physio- 
logic function alone is the 

object of the examination. The material used is 
adapted to the power of the child to identify objects. 
Before the child knows his letters he may be supposed 
to identify objects. For this period of development 
the late Doctor Wendell Reber, of Philadelphia, has 
constructed a "Kindergarten Test Card" (published 




Fig. 13. 
Doctor Reber's kindergarten chart. 



298 THE EXCEPTIONAL CHILD 

by the Mclntyre, Magee and Brown Co.) of which 
he says: 

The chief points in the construction of any object test-card 
are that (i) it shall consist of objects readily recognized by 
little children; (2) the objects should conform as nearly as 
possible to the accepted scientific standard by subtending the 
correct angle for a distance of 6 metres. I doubt whether an 
absolutely scientific object test-card, in the sense just men- 
tioned, will ever be constructed. In the very nature of things 
they will have to be approximations. . . . The first three 
objects (the dog, the horse, and the cat) are of value because 
they are almost immediately recognized by even very young 
children. . . . The remainder of the objects figured lend 
themselves more completely to the correct angular construc- 
tion. The circle or ring is of value in estimating spherical 
errors. The flag and window are of value in indicating some 
variety of rectangular astigmatism, while objects like the star, 
the scissors, and the gate are of value in the indications they 
give as to some form of oblique astigmatism. Such objects as 
the hat, the hammer, the hand, and the cup are far from being 
scientifically satisfactory, but some objects must be introduced 
for variation and these have been found to serve fairly well. 

Where a difficulty is found in the identification of 
these objects (this difficulty may be a mental one), it is 
well to employ still simpler methods of determining the 
physiologic function. The E-fork test was invented by 
the late Professor Herrmann Cohn, of Breslau, the pio- 
neer in testing the eyes of school children. It presents 
the capital letter E in various positions, which can be 
indicated by the child with the use of a large pasteboard 
form of the letter, resembling a fork with three prongs. 

A few years ago the McCallie Vision Tests (published 
by Edwin Fitzgeorge, Trenton, N. J.) have been brought 
into the market. The illiterate set of these cards are an 
inexpensive substitute for the Cohn test, representing a 



SCHEDULE OF TESTS 299 

boy, a girl, and a bear, playing hoop-ball; the ball is 
seen in different hoops and the child can state in which 
he sees it. 

Children who know their letters can be tested with 
the ordinary Snellen test-cards, which are known to 




Fig. 14. 
McCallie's illiterate vision test. 

every one; or with the "literate set" of the McCallie 
cards. In all cases great care must be taken to have 
proper illumination and to be sure of the distance from 
which the characters are recognized. Guard against 
guessing on the part of the child. Each eye must be 
tested separately, the vision of the other eye being ob- 



300 THE EXCEPTIONAL CHILD 

structed. Any difficulty or inequality in vision should 
lead the examiner to a closer scrutiny of the child's 
visual power, which can be tested only with the proper 
instruments and by an expert oculist. Avoid the seller 
of glasses! 

Color Perception. — The next test refers to color per- 
ception. It consists of two parts. The first one merely 
tests the physiologic junction of color perception and dis- 
crimination, without requiring the naming of the color. 
This test will lead to the detection of possible color- 
blindness which, if present, would naturally confuse the 
child's ability to name a color rightly. The test is made 
by having the child match colors; first the six primary 
colors: red, orange, yellow, green, blue, and violet; 
secondly, a selection of tints and shades of these; and 
perhaps some intermediates and neutrals. Black and 
white may be added if desired. For this test we may 
use either colored worsted, the strands of which should 
be mixed up for the child to assort; or colored papers of 
any standard series. The author uses the sample book 
of the Prang series. The colored papers measure 1x4 
inches. These are pasted upon white (or neutral-col- 
ored) cards, 3x5 (the standard library record card), 
and are then cut in half, thus producing two pieces 
which can be matched together. 

Naming colors correctly depends in a large measure 
upon a child's opportunity of individual experience and 
school training. If in spite of such opportunity and of 
the integrity of his physiologic function the child fails 
to name colors correctly, there is clear evidence of men- 
tal impairment in this field. 

Visual Memory. — The third visual test is a test of 
memory. This, like the test of aural memory described 



SCHEDULE OF TESTS 301 

later, is of the utmost significance in determining the 
causes of a child's backwardness and failure in school. 
The psychologic function which we call memory is not 
in itself an intellectual quality. It has distinct physio- 
logic elements and is otherwise in the nature of a 
psychic mechanism. 1 In not a few cases a good mem- 
ory is found in persons manifestly inferior in intellect, 
while it is frequently weak in persons of high intelligence, 
at least along certain lines. A distinction is often made 
between a mechanical and a logical memory. It may be 
said, however, that the justification is doubtful. All 
memory is essentially ''mechanical." Where there is 
no logical mind to make the proper use of this tool, 
memory work will retain its mechanical elements in an 
unarticulated form. When, however, a rational mind 
controls the memory mechanism, it is elevated into a 
sensible thing and becomes a powerful machinery for 
mental development. It is, of course, possible to imag- 
ine that such a mind may neglect to make the best use 
of this memory tool; or the tool, in its physiologic 
aspect, or in its psychologic development, may be de- 
fective. Then we have the good mind unassisted by 
memory, and losing much of its efficiency through the 
absence of the tool. "To remember" implies the men- 
tal faculty of raising stored-up impressions across the 
threshold of consciousness. Various conditions affect 
this power. 

In these tests we wish to determine primarily the 
degree of efficiency which the mind has achieved in 
using the memory tool at the time of the examination. 
In a measure these memory tests are also tests of atten- 
tion. Group K of this schedule of tests has, however, 
1 Cf. p. 150. 



302 THE EXCEPTIONAL CHILD 

special reference to the power of the child to concen- 
trate, and should be utilized to check off the results 
obtained here. Attention enters into so many other 
tests, for that matter, that all our observations will 
furnish a composite picture of this fundamental quality 
of mental activity. 1 

Three tests are applied for visual memory. For the 
first of these the author uses wooden balls painted in the 
primary colors; of course balls of any other material, or 
colored papers, may be substituted, really any other 
colored objects, provided that the purpose of the test, 
viz., to emphasize color, not the form or character of 
the object, is kept in mind. For this reason simple balls 
or papers are preferable. 

For the second test a number of familiar objects' are 
used: ball, book, chalk, fork, knife, spoon, napkin, ham- 
mer, bottle, paper, key, ruler, etc. In this test the 
object itself must be remembered. 

The method of presentation is as follows : 

The child is placed at a suitable distance from a 
table on which there is a dark screen behind which the 
colors or objects are hidden. They are exposed momen- 
tarily in sets of increasing number: 2, 3, 4, 5, 7, 
and more. The child is asked to repeat the names of 
the colors, or of the objects, in the order in which they 
were presented, and is warned not to begin until all the 
colors or objects of the series have been exposed, and 
until the examiner tells the child to begin. It is allow- 
able to repeat a number-series, provided new colors, or 

1 Power of attention and concentration, as well as the exercise of all 
other physiologic, psychologic, and mental functions, depend so much 
upon the child's nerve force and endurance that the element of fatigue 
must be reckoned with. More will be said on this point when the final 
summary will be discussed. 



SCHEDULE OF TESTS 303 

objects, or a new arrangement or sequence are substi- 
tuted. For example: If a child cannot repeat the three- 
series red, blue, yellow, a second test with three colors 
may be given, like orange, green, violet. Likewise with 
objects. The purpose of this repetition is to set the child 
at ease. Often he will fail at first, owing to the strange- 
ness of the task, and we should give him the benefit of 
the doubt. The repetition also shows the child's ability 
to profit from experience. Let us remember that the 
purpose of these tests is not to establish standards, but to 
understand an individual child. 

We may even construct, with a small number of 
colors and objects, longer series, of 10, 15, 20 and mor*e 
units, if needs be, by rearranging the units and repeat- 
ing individual units at different places. Thus, a series 
like this may be presented: Knife, hammer, paper, ball, 
chalk, hammer, book, fork, knife, spoon, bottle, paper, 
key, ruler, napkin. Long series like these, if remem- 
bered, would indicate an unusual power of visual mem- 
ory. The examiner must be prepared to meet any kind 
of child mind. 

The first of these memory tests naturally presup- 
poses the child's ability, as previously determined, to 
distinguish and name colors. The objects are so well 
known to every child that their identification should 
be easy, unless we are dealing with a low defective. 
This test is therefore related to Group L of this schedule. 

The third test for visual memory is the reading of 
words, from cards on which one word each is printed, 
and which are exposed in the same manner in which the 
colors and the objects were exposed. This test applies 
only to children who can read. While it is principally 
a memory test, it will allow of conclusions regarding the 



304 THE EXCEPTIONAL CHILD 

quick identification of words. The words are printed 
in clear, bold type, three inches high (so that there can 
be no trouble about seeing them accurately with fairly 
normal power of vision), on pieces of stiff cardboard, 
about 5 x 10. The following sets have been selected 
(the words in italic are printed in red) : 

(i) Cow, room, ship, queen, hammer; (2) road, glass, board, 
bell, pencil, water; (3) garden, stone, grass, dog, bottle, hill, wall; 
(4) house, statue, paint, ink, door, picture, cloud, tree; (5) paper, 
roof, sky, pen, leaf, hammer, cow, ship, bottle, door. 

All that was said before in relation to the handling of 
colors and objects in presentation holds good with the 
use of the words. 

Any confusion in the order of the colors, objects, or 
words presented, or any incompleteness of the series 
given, especially after several tests, would prove that 
the child is weak in visual memory to the degree indi- 
cated by the series used. Such a weakness will naturally 
prevent a child from profiting from his lessons and 
experiences, as these cannot be retained, and if retained 
are not stored away in the mind in the proper sequence 
and order. In a number of cases the very same exercises 
which are here used as tests may be applied in school for 
the training of the memory faculty, which can be trained 
in most of us by the patient application of the proper 
methods. 

Unrelated words and objects are used here to elimi- 
nate entirely the action of judgment from this test of 
mechanical memory. 

B. Auditory Tests. — While it is relatively easy to 
detect disturbances in the province of vision (except 



SCHEDULE OF TESTS 305 

color-blindness) even without special testing, and to 
understand the consequences of\impaired vision in the 
matter of learning and of intellectual progress, the child 
who is hard of hearing is not so easily discovered as suf- 
fering from this specific sense defect. This is owing to 
the fact that the partially deaf child has learned to rely 
upon his eyesight and his other sense-impressions for 
conveying messages to him, and the art of lip-reading 
comes to him almost unconsciously. The child himself 
has rarely an idea of his defect, but thinks that his 
method of getting information from what other people 
perceive as " sound" is perfectly natural. He has no 
standard of comparison. And inasmuch as he seems 
to hear, his parents and teachers do not realize the fact 
of his difficulty. Sometimes, when he does not see the 
lips of the one to whom he appears to listen (as when 
it is dark, or the speaker has his face averted) , or when 
his other substitute sense-impressions fail him, he does 
not "hear," and is then suspected, not of a physical 
defect, but of inattention, even of disobedience and 
perversion. 

The author had a little boy (Case 65) under exami- 
nation in his clinic recently who was a member of a 
special class and had made no progress for years although 
he looked bright. His tests indicated intelligent judg- 
ment in many ways. He was thought to be "a little" 
hard of hearing — so much had been found out; but when 
the child was discovered to be unable to hear the exami- 
ner's voice, blindfolded, at the distance of only one foot 
from either ear, his teacher raised her hands in amaze- 
ment, never having suspected that "it was as bad as 
that." 

In order to impress his readers with the very great 



306 THE EXCEPTIONAL CHILD 

importance of auditory tests, the author will once more 
refer to Arno Miiller's investigation on hardness of 
hearing as the cause of apparent alexia and agraphia, 
quoted on pages 144 jj. 

Auditory test 1 refers to the distance over which a 
child can hear. He is either blindfolded or placed with 
his face away from the examiner. The examiner tests 
each ear separately (the other ear being covered with the 
hollow hand, either of the child himself or of an accom- 
panying teacher or assistant, or closed with cotton), 
saying easy words or sentences for the child to repeat, 
from varying distances, first in the ordinary tone of 
voice, then in a whisper, taking care to articulate care- 
fully. Even the whisper should be heard with normal 
power of hearing across a room of ordinary size, every- 
thing being quiet. Every diminution of hearing power 
gives rise to the suspicion of functional defect and calls 
for expert examination. 

For tests 2, 3, and 4 the child is blindfolded. At 
varying distances from the child, different noises and 
sounds are produced: Scratching, tapping wood or metal, 
striking of a bell, whistling, etc., with varying degrees 
of loudness. The child is expected to identify the nature 
of the sound and the place or direction whence it comes. 
Grave errors are danger-signals. 

For test 4 the author uses a simple "piano" from 
the ten-cent store. The child is asked to state whether 
one tone is higher or lower than the one previously 
struck. While there is a physiologic element in this 
test, its result also depends upon experience and training. 
Sometimes the nature of the test will have to be ex- 
plained to the child before he can be justly graded as 
normal or defective in perceiving pitch. 



SCHEDULE OF TESTS 307 

The same simple instrument is used for test 5 (a). 
One tone is taken as the basis of the experiment. It is 
struck several times and the child (blindfolded) is asked 
to remember it carefully. Then another, much higher or 
lower tone is sounded. The child is asked, "Is this the 
same tone?" Next, the experimenter goes back to the 
basic tone for identification. Two or more, also less 
widely different tones are struck next, before the original 
tone is repeated. In another form of the experiment the 
child is asked to find the basic tone by striking the 
keys with the little hammer himself until he finds it, if 
he does at all. The object is to detect how reliable the 
child's faculty is to identify a given tone. The result is 
interesting for determining whether the child has a 
"musical ear"; if he has, it may become a valuable 
asset. 

For test 5 (b) the same sets of words are used which 
we had in the visual-memory test. Here the words are 
pronounced slowly and carefully to ascertain the aural - 
memory span and accuracy of retention. What has 
been said about method and significance of the visual 
test with words is applicable here, with the modification 
conditioned by the use of another sense. 

Test 5 (c) introduces a number of graded selections 
to be read slowly to the child, once, twice, even three 
times. The child is then requested to repeat the selec- 
tion, and the number of memories is noted down. Each 
selection contains a certain increasing number of memo- 
ries (in the reproduction below they are separated by 
dashes), and the child should normally retain at least 
50 per cent of the total number to represent the period. 
The selections are called "word pictures," as they are 
so chosen that they may call forth in the child's mind 



308 THE EXCEPTIONAL CHILD 

very distinct mental images. These images may be 
visualized; but the avenue of perception is sound. 

The reproduction may be oral or in writing. 

The series is so arranged that there is an advance 
from one period to another, in the matter of difficulty, 
language, content, interest, etc. 

For the Primary Period the following selections are 
used, in the order given here : 

(i) Snowing 
Katie / likes to see it snow. / She has a little sled. / She takes 
the sled / to the top of the hill / and gets on it. / Then she rides 
down the hill / as fast as she can go. / As she goes down the 
hill / she sings: / 

"Old woman, old woman, old woman / so high, / 
You are picking your geese. / the white feathers fly." 
(14 memories.) 

(2) Playing Housekeeping 
(This selection is used preferably for girls) 
Little Kate / is playing housekeeping. / She likes to think / 
that she is a little mother. / The dolls / are in the playhouse. / 
The little baby doll / has on a white bib. / Kate gives her 
mush / out of a brown pitcher. / The big doll / sits up / and 
has a crust of bread / in her hand / which Kate has given her 
to eat. / 

Kate says: / "I must now dust / the chairs / in your house, / 
dear dollies. / I must scrub the house, too. / 

"Now it is time for me to dress my dolls. / I will brush their 
hair. / I will put the blue dress / on big Fannie. / Little Bess / 
will look fine in pink." 

(27 memories.) 

(3) In the Barn 
(This is a boy's selection) 
When it is raining / we cannot play / under the trees. / We 
then go to the barn. / There are many things to see / in grand- 
father's barn. / 



SCHEDULE OF TESTS 309 

There is the old horse / standing in his stall / eating hay. / 
A white hen / is sitting on her nest / in the loft. / Ned / set 
her on ten white eggs. / The little chicks / will come out / of 
the egg-shells. / 

The black hen / has her nest / under the pig-pen. / It is 
hidden / in the leaves / so you cannot find it. / In this nest 
there are six eggs. / 

Ned keeps the cows / in a stall / under the shed. / They will 
give us good milk. / There are many mice / and rats / in grand- 
father's barn. 

(31 memories.) 

For the following periods one selection only is pre- 
sented for each. 

Elementary Period: 

Trusty Helpers 

Man / has many good helpers / among the animals, / but 
there are only two / that can be trusted / to do their work 
alone. / These two are the dog / and the elephant. / 

Books have been written / about dogs / and the wonderful 
things they have done. / They run errands / and care for sheep / 
and cattle. / They rescue / travellers / who have been lost in 
the snow. / and do no end of strange things. / 

The elephant, too, / has been taught / to do many wonderful 
things. / He is so strong / that he can carry heavy loads. / He 
is so gentle / that little children have been left in his care. / 
He is so trusty / and faithful / as to be a model for all. 
(28 memories.) 

Intermediate Period: 

Ploughing 

All day long / the ploughmen / on their prairie farms / have 
moved to and fro / on the wide, level field / through the fall- 
ing snow / which melted as it fell, / wetting them to the skin / 
— all day, notwithstanding / the frequent squalls of snow, / 
the dripping, desolate clouds, / and the muck of the furrows, / 
black / and tenacious / as tar. / 



310 THE EXCEPTIONAL CHILD 

Under their dripping harness / the horses / swung to and 
fro / silently, / with that marvellous, / uncomplaining patience / 
which marks the horse. / The ploughman behind his plough, / 
though the snow lay / on his ragged greatcoat, / and the cold, / 
clinging mud / rose on his heavy boots, / whistled / in the 
very beard of the gale. / 

As the day passed / the snow, / ceasing to melt, / lay along 
the ploughed land / and lodged in the depth of the stubble, / 
till on each slow round / the last furrow / stood out black / and 
shining as jet / between the ploughed land / and the gray 
stubble. 

(41 memories.) 

Advanced Period: 

Early Dutch Fireplace Scene 

To have seen a numerous household / assembled round the 
fire, / one would have imagined / that he was transported / 
back to those happy days / of primeval simplicity / which fleet 
before our imaginations / like golden visions. / The whole 
family, / old and young, / master and servant, / black and 
white; / nay, even the very cat / and dog / enjoyed a com- 
munity of privilege, / and each had a right / to a corner. / Here 
the old burgher / would sit in perfect silence, / puffing his 
pipe, / looking in the fire / with half-shut eyes, / and thinking 
of nothing / for hours together; / the good wife, / on the oppo- 
site side, / would employ herself diligently / in spinning yarn / 
or knitting stockings, / listening / with breathless attention / 
to some old crone of a negro / who was the oracle of the family, / 
and who, perched like a raven / in the corner of the chimney, / 
would creak forth, / for a long winter afternoon, / a string of 
incredible stories / about New England witches, / grisly ghosts, / 
horses without heads, / and hairbreadth escapes / and bloody 
encounters / among the Indians. 

(44 memories.) 

Caution must be exercised not to value the returns to 
these tests for anything else but aural memory, which 
may be purely mechanical. They are not intended as 



SCHEDULE OF TESTS 311 

tests of an intelligent understanding of the text pre- 
sented, at least not primarily so. The examiner may 
find that the child, in reproducing the word picture, will 
so word it that it is not merely a mechanical account 
but a testimony to his understanding as well. In this 
case the test under M, 2, will be superfluous. 

C. Tactile Tests. — The purpose of the tactile tests 
is to ascertain to what extent the child has the ability 
to discern objects through touch alone. The result de- 
pends, of course, first upon the physiologic integrity of 
the child's tactile sense; second, upon his psychologic 
faculty of interpreting percepts; and thirdly, upon the 
degree and extent of his experience. Schooling and in- 
struction enter more particularly into the differentiation 
of geometric form. Naturally mental ability as such is 
also a factor, but it is not the one which is primarily 
tested in this set of tests. However, in the event a child 
fails to respond properly in this field, the suspicion is 
justified that the underlying cause is a brain defect. 
The further tests in concentration, judgment, discrimi- 
nation, etc., will reveal the mental defect if it should 
exist; if this is not made evident by those further tests, 
the conclusion is justified that failure in sense-percep- 
tion is due to imperfection in the sensory apparatus. 

In making the tests the child is either blindfolded or 
simply turned with his face away from the experimenter. 
With his hands held open behind his back the child is 
invited to enjoy a "guessing game" by having placed 
in his hands various objects, such as a ball, large key, 
shoe, paper, various goods (wool, silk, cotton, sand- 
paper, etc.), and other things. In the second series we 
introduce smaller objects: pocket-knife, pen-points, small 



312 THE EXCEPTIONAL CHILD 

keys, marbles, nails, etc., also a greater variety of fab- 
rics. The geometric forms of the third series should con- 
sist of cubes of various sizes, small balls, cylinders, prisms, 
as well as flat forms (squares, circles, triangles, ovals). 

Tactile test 4, which is essentially physiologic, is 
made with the help of a simple piece of apparatus. Use 
ordinary large bottle corks, up to 2^ inches in diameter, 
and drive into them, point downward, large sewing- 
needles at different distances from one another (from 
2 inches down to yi inch), and have one with a single 
point. Care must be taken that the double needle- 
points are on a level. 

With the child blindfolded touch various body areas 
(palm and back of hand, wrists, other parts of the arm, 
neck, face, etc.) to ascertain whether the correct num- 
ber of points, one or two, is perceived. The back of 
the hand is naturally duller in tactile perception than 
the palm, and so there are other natural differences. 
Nevertheless, surprises are in store for the experimenter, 
who must not lose sight of the fact that the child may 
be the victim of self-suggestion in some of his answers. 
In this test we cannot expect to state minute results — 
that is not the function of an educational clinic. All we 
can expect to do is to find whether there is a large de- 
gree of insensibility to tactile impressions (anaesthesia), 
or an exaggerated sense of touch with the immediate 
ability to make fine distinctions. 

D. Sense of Smell. — For short examinations the 
testing of the senses of smell and taste may be omitted, 
except in cases where the major senses, sight, hearing, 
and feeling, seem inoperative and, therefore, the minor 
senses, so called, have to assume the functions of the 



SCHEDULE OF TESTS 313 

major, as far as possible. It may, however, be surpris- 
ing to observers how much the keenness of the minor 
senses varies in different individuals, and how often 
children of underdeveloped mentality suffer from a 
dulness in these spheres which contributes to the 
meagreness of their sense-impressions. Yet out of these 
sense-impressions their conceptual world is to be con- 
structed. 

Few of us are conscious how much the sense of smell 
contributes to our conceptual world, and how distinctly 
it affects even our emotional states. Dulness of this 
sense is therefore disadvantageous to the otherwise 
efficient and normal individual no less than to the one 
who is already handicapped in other directions. 1 

The series of smelling tests comprises, first, the iden- 
tification of simple and familiar odors, like that of soap, 
vinegar, coffee, cocoa, flowers, fresh bread, perfumes, 
etc. For acuteness, graded extracts of musk, violet, 
orange, vinegar, etc., are used, varying between 10 per 
cent and ioo per cent of strength. They are prepared 
with pure alcohol as a solvent. 

Dulness of sense is always a danger-signal. Olfac- 
tory dulness may be indicative of catarrhal conditions 
of nose and throat. 

1 While civilized man relies mostly upon the senses of vision and hear- 
ing, savage peoples make use of the keenness of their sense of smell in 
a number of ways. Alexander von Humboldt, many years ago, re- 
ported that the Indians of Peru can follow the trail of animals or of 
enemies by scent as well as any dog. Modern examples of similar 
observations are numerous. If we now consider that some of our diffi- 
cult children represent a primitive type we may be warned that keen- 
ness of their sense of smell may not only be symptomatic, but also very 
useful to them if they are less gifted in seeing and hearing. It can often 
be observed that children of " impaired mentality " have the tendency 
to " smell " everything they handle. 



314 THE EXCEPTIONAL CHILD 

E. Sense of Taste. — Like the sense of smell, gusta- 
tory sensations depend, first, upon the functional integ- 
rity of the sense-organ, the tongue. Catarrhal and 
digestive conditions may coat the tongue and impair 
its function. But it is plain that the elements of ex- 
perience and of training enter very largely into the 
identification and naming of impressions. 

Elementary tests determine the child's ability to 
recognize the taste of sugar, salt, chocolate, bread, fruits, 
vinegar, etc. For the graduated tests for acuteness use 
graduated solutions (in distilled water) of sugar, salt, 
vinegar, and quinine, varying between 10 per cent and 
ioo per cent of strength. Mark first traces of sweet, 
salt, sour, bitter. 

For both the smell and the taste tests the child is 
blindfolded. 

F. Motor Co-ordination. — This test would seem to 
be merely one of physiologic function. An element of 
judgment, however, is infused by placing before the 
child not only a graded series of needles, but also threads 
of different degrees of fineness or coarseness, so that he 
must choose the one which can be used best in threading 
a certain needle. Children of weak judgment will try 
forever to fit a shoestring into an ordinary darning- 
needle, or put a cotton thread into the biggest eye or 
eyelet of the selection — not for a moment considering 
the use of the right size. 

The larger "needles" used in this test are in reality 
pieces of iron or steel, about four inches long, round in 
shape, with correspondingly large openings at one end. 
The largest is an iron bar y% of an inch in diameter; the 
smallest one of y& inch diameter. Shoestrings or cord 
are used for threading them. 



SCHEDULE OF TESTS 315 

For these a cheap and fully satisfactory substi- 
tute are bodkins for various widths of ribbon or 
tape. 

Then we use a series of real needles, beginning with a 
large darning-needle, down to a fine sewing-needle. 
Cotton and silk thread of various sizes are used for 
threading. 

Observation of the manner in which the children han- 
dle the cube, pegs, insets, etc., in the other tests will 
give further clews to the degree of their motor co- 
ordination. 

G. Sense of Location. — The sense of location de- 
pends upon proper physiologic function coupled with 
sufficient individual experience. It is not well defined 
in psychologic experiment and terminology, but has a 
practical bearing upon a child's ability to locate himself 
in space. The muscular sense, while now recognized as 
a specific sense, is also still vague in its actual operation. 
If the Rolandic area (p. 135) is the seat of motor memo- 
ries, we may find in it a centre for the ability of an indi- 
vidual to locate himself. 

This activity requires attention in a system of tests, 
as it determines much of a child's practical self-direction 
or helplessness. 

First Test: Examiner points out some object in room. 
Then blindfolds child and asks him to walk toward 
object. 

Second Test: Have child walk several times with eyes 
open from door to window (or any other similar task), 
taking care that the path chosen is not direct but 
winding and roundabout; then blindfold him and have 
him retrace his steps in this manner (muscular mem- 
ory)- 



316 THE EXCEPTIONAL CHILD 

H. Balance. — For tests of balance use these: 

i. Child to walk along straight line (marked on floor 
as plainly as possible). 

2. Standing in Romberg position (feet extended 
straight forward and put close together, eyes closed). 

Disturbances in the static apparatus (in the inner 
ear) are the result of local disease, or indicate other 
nervous handicaps. They are often connected with im- 
pairment of the visual apparatus. A child having such 
disturbance will sway and fall when walking along a 
straight line in the manner described in the test; and 
he will almost immediately fall forward when standing 
in Romberg position. 

/. Train of Ideas. — This test is intended to sound, 
in a measure, the child's power of association, and also 
to discover his trend of thought. Prevalent mental and 
moral tendencies may be revealed. 

The words selected as guide words are hammer, book, 
and mother. They represent three circles of experience: 
the child's activities and human occupations in general; 
the school circle, and the home circle. 

The examiner will ask the child to listen carefully to 
the word which he will pronounce, and then to tell 
whatever other words or thoughts come into his mind 
after hearing the word. It may be necessary to explain 
the meaning of the direction several times, so as to be 
sure to have the child understand, as otherwise the pur- 
pose of the test would be vitiated. Only as many words 
are recorded as can be given within three minutes. 
The words may either be dictated to the examiner or 
written down by the child. 

While the number of associated ideas counts for some- 



SCHEDULE OF TESTS 317 

thing, the main object is to obtain the associations 
themselves. They may give a clew to the individuality 
and to the individual needs of a child. A mere enu- 
meration of words, without associated ideas, would 
indicate dulness of conception; if a child, as the author's 
records show, gives a series of words which rhyme, or 
have the same phonetic elements, or belong to the same 
orthographic type, the association would be of a nature 
to emphasize the child's scholastic interest. (Cf. p. 258.) 

Here is the record of a peculiar case (Case 67), which 
throws light upon the life conditions of the boy under 
observation. He is a little Italian boy with insanity 
in the family history. This is what he said when the 
word "mother" was given: "Italian — makes me sorry — 
makes me think — I feel bad — I ain't got good care — I 
just have the same blood." His father is living, but his 
mother died in an insane asylum. The father is a tailor, 
very poor. Armando is one of sixteen children, all of 
whom died in infancy, except four boys; one brother, 
quite "smart," died at the age of 22, insane. The little 
boy has hardly any care. It is easy to draw interesting 
conclusions without knowing much else about the child's 
mentality. 

The case illustrates the necessity of making the 
directions elastic, and not insisting upon "words," or 
"nouns" only. 

/. Imitation. — Imitation is one of the earliest and 
most fundamental faculties developing in the child. It 
is distinctly psychologic in character and combines 
readily with other mental operations, so readily, indeed, 
that a purely imitative act is hardly ever observable 
after earliest childhood. Pure imitation would be al- 



318 THE EXCEPTIONAL CHILD 

most reflex in character. An imitative act requires 
attention to the act to be imitated, and concentration 
upon its details. There must be a certain amount of 
rational judgment to discriminate between the more or 
less essential elements of the act to be imitated, so as 
to make the imitation perfect. 

First Test: Movement. — The first test consists in ask- 
ing the child to imitate a certain movement, like 
swinging your arms in a particular manner, or going 
through a short series of calisthenic exercises. The de- 
gree of accuracy in the reproduction of this movement 
will be an index of the child's ability to observe and 
imitate. Of course, it implies a test in motor co-ordi- 
nation. 

Second Test: The Knox Cubes. — The Knox Test is 
one of those employed at Ellis Island for the testing of 
immigrants suspected of mental defect. It is described 
by its inventor, Doctor Howard A. Knox, of the United 
States Public Health Service, as follows: 

Four i-inch cubes, 4 inches apart, are fastened to a piece of 
thin boarding. The movements and tapping are done with a 
smaller cube. The operator moves the cube from left to right, 
facing the subject, and after completing each movement, the 
latter is asked to do likewise. Line (a) is tried first, then (b), 
and so on to (e). Three trials are given if necessary on lines 
(a), (b), (c), and (d), and five trials if needed on line (e). To 
obtain the correct perspective the subject should be two feet 
from the cubes. The movements of the operator should be 
slow and deliberate. 1 

If the cubes are numbered 1 (red), 2 (blue), 3 (green), 

1 "A Scale, Based on the Work at Ellis Island, for Estimating Mental 
Defect." The Journal of the American Medical Association, March 7, 
1914. 



SCHEDULE OF TESTS 



319 



(a) 



(M_l 1 



(G) 



M 



(d) 



ilFl li^l 



\ 



(e) 



/ 



^=sV 



Fig. 15. 
The Knox cube test. 

and 4 (yellow), respectively, the movements are as fol- 
lows: 

(a) Touching the four cubes successively with the small cube, 
then putting the small cube down on the table. 

(6) Touching the four cubes successively, then going back to 
cube 3, then down. 

(c) Touching the four cubes successively, then back to 2, 
then down. 

(d) From 1 to 3, back to 2, then to 4, then down. 

(e) From 1 to 3, to 4, back to 2, to 3, back to 1, then down. 



320 



THE EXCEPTIONAL CHILD 



The author is using larger cubes, two inches, natural 
wood only, and does not have them fastened to any 
board. There seems to be no special value in the size 
or color of the cubes, or their distance from one another, 
as long as they are distinct enough from one another to 
be recognized as separate entities. In fact, one of the 
special advantages of this nice test is its adaptability 
to any emergency. Instead of cubes the author has 
used visiting-cards, playing-cards, or anything else handy 
that lent itself to the following out of the proper move- 
ments. 

Using the Binet method of grading, Doctor Knox puts 
the ability to do test (a) under the age of 4 years; test 
(b) under 5 years; test (c) under 6 years; test (d) under 
8 years; test (e) under n years, the years representing 
the normal age at which he thinks the test can be per- 
formed. He uses the following table of grading "men- 
tal age": 



Age 
At or Over 


Mental Development 
Years 


Classification 


6 
6 
8 
10 
12 
12 
14 


Practically none 
1 
2 

2-4 
4-6 
6-8 
8-10 


Low-grade idiots 
High-grade idiots 
Low-grade imbeciles 
Middle-grade imbeciles 
High-grade imbeciles 
Low-grade morons 
High-grade morons 



According to this schedule, normality would be indi- 
cated by performing all five tests successfully. As a 
matter of fact, the author has found children of other- 
wise rather low ability to perform all five tests with 
relative ease, and intelligent adults who stumbled over 
the fourth. Nevertheless, the test is very valuable 



SCHEDULE OF TESTS 321 

when taken in connection with the other tests. In test- 
ing adults of ordinary intelligence we must never forget 
that they lack the unsuspecting nature of the child; 
they will anticipate being caught in a trick in which the 
apparently unessential plays a part. 

Third Test: Peg-Board. — This test is related to those 
Binet Tests which require the drawing of a square and 
a diamond. It has been empirically found that the 
drawing of a diagonal requires a higher development 
than the drawing of a horizontal or vertical line, what- 
ever the cause may be. Binet puts the drawing of a 
square under the " mental age" of 6; the drawing of a 
"diamond" one year higher, 7. Instead of the draw- 
ing the author employs a large peg-board, which gives 
opportunity for an easier motor adjustment and at the 
same time serves the purpose of discovering the child's 
mental development. It has been found that the in- 
ability to imitate the "pegging" of a diagonal, or of 
a parallel to the diagonal, or the making of a diagonal 
from direction, is a strong indication of mental under- 
development, whatever the cause may be. 

This exercise has been placed under "imitation," feel- 
ing that it involves this kind of mental activity pri- 
marily, while it may be based upon visual conception 
causally. 

K. Concentration. — The tests enumerated under this 
heading require close attention to be given by the child, 
and the first two presuppose a certain degree of mem- 
ory power. These two will therefore add further data 
to the memory quality of the child's mind. 

Following Directions. — The Binet Tests require for the 
"mental age" of 6 the performance of three commis- 



322 THE EXCEPTIONAL CHILD 

sions given simultaneously. The author finds that it is 
well to grade the performance of commissions by begin- 
ning with one, and then trying longer series. Thus, to 
a younger child, or one whose power we do not feel able 
to conjecture, we give just one commission, as: "Hand 
me the book from the table!" or "Open the door!" and 
observe with what promptness and success it is carried 
out. The second step involves two different actions 
successively, e. g., locking the door and bringing you 
the key, or raising arms over head and lowering them 
behind the back. The number of commissions thus 
given can be increased, even to five, six, or seven and 
more. The author has had subjects carry out a dozen 
and more commissions without a single mistake. The 
success with which they are carried out is a fair measure 
of the ability of the subject to concentrate — not neces- 
sarily of anything else. It is interesting to note, how- 
ever, that children whose visual and auditory memory 
(pp. 300 and 307 jf.) was limited, were often surprisingly 
successful in holding a long series of simultaneous direc- 
tions in their minds. 

It is easy to see that this test is not one to require a 
special time. It may well be combined with other tests. 
In other words, the success with which a child carries 
out the directions and instructions required to perform 
other tests, if they involve a sequence of activities fol- 
lowing one simultaneous direction, may well be recorded 
in this place, making a separate test superfluous. 

Remembering Objects. — The second test here suggested 
is not identical with the test for visual memory, as 
under A, 3 (b), as might be suspected at first glance. 
In the visual-memory test the objects are shown suc- 
cessively. In this test they are exposed simultaneously. 



SCHEDULE OF TESTS 323 

A certain number of familiar objects, three, five, or 
more, are arranged on a table while the child is not 
looking, or behind a screen, or under a cloth. These 

OYKFIUDBHTAGDAACDIXAMRPAGQZTAACVAOWLYX 

WABBTHJJANEEFAAMEAACBSVSKALLPHANRNPKAZF 

YRQAQEAXJUDFOIMWZSAUCGVAOBMAYDYAAZJDAL 

JACINEVBGAOFHARPVEJCTQZAPJLEIQWNAHRBUIAS 

SNZMWAAAWHACAXHXQAXTDPUTYGSKGRKVLGKIM 

FUOFAAKYFGTMBLYZIJAAVAUAACXDTVDACJSIUFMO 

TXWAMQEAKHAOPXZWCAIRBRZNSOQAOLMDGUSGB 

AKNAAPLPAAAHYOAEKLNVFARJAEHNPWIBAYAQRK 

UPDSHAAQGGHTAMZAQGMTPNURQNAIJEOWYCREJD 

UOLJCCAKSZAUAFERFAWAFZAWXBAAAVHAMBATAD 

KVSTVNAPLILAOXYSJUOVYIVPAAPSDNLKRQAAOJLE 

GAAQYEMPAZNTIBXGAIMRUSAWZAZWQAMOBDNAJZ 

ECNABAHGDVSVFTCLAYKUKCWAFRWHTQYAFAAAOH 



Name .. i ..... < 
Time in seconds 



Columbia University Experiment Form.) 

Fig. 16. 
The one hundred A's test. Test in concentration. 

objects are then momentarily exposed and the child 
asked how many and which he can remember. There 
is here no need of insisting upon a certain order. What 
is being tested is the rapid concentration of attention. 
Test of too A's. — Test 3 requires the striking out of 
100 A's scattered through a block of 500 capital letters. 



324 THE EXCEPTIONAL CHILD 

This test was first suggested by Professor Nosworthy of 
Columbia University, and has become a well-known 
standard method of testing concentration. The percen- 
tage of A's stricken out and the time consumed (in sec- 
onds) is noted. By repeating the test, the effect of 
habit, practice, and fatigue can be studied. 1 

Defective concentration is one of the most potent 
causes of failure in school work. 

L. Naming of Objects. — This test is intended to 
determine, approximately, the range of a child's experi- 
ence and vocabulary. It is rather elementary in char- 
acter, yet may be extended at will and may give some 
remarkable revelations to the examiner. The range of 
experience varies considerably with different children, 
irrespective of their mental capacity. Its limitations 
will throw light upon other failures which could not 
otherwise be understood. After all, no superstructure 
of knowledge can be built upon too flimsy a foundation, 
and these elements of knowledge, tested as here sug- 
gested, form the apperceptive basis for all further in- 
struction. Earlier studies in experimental education 
have shown that the contents of children's minds before 
entering school must be definitely known before teach- 
ing can be a success, and it has been demonstrated that 

1 The Training School, Vineland, of May, 1913, contains a report on 
experiments with the A test on the feeble-minded. The conclusions 
are that it is not reliable for the testing of mental defectives, partly 
because of the lack of correspondence between the results obtained and 
intellectual ability. "There is no relation between this test and chrono- 
logical age. . . . Sex differences are not very significant, though show- 
ing a slight superiority of girls over boys. . . . The A test is valuable 
as an individual psychological experiment, but is not in this respect 
superior to other tests yielding more reliable objective results." No 
mention is made as to what these other tests are. 



SCHEDULE OF TESTS 325 

we take only too often the knowledge of things for 
granted when the child has in reality no clear knowledge 
of them at all. It is also a distinct step from identify- 
ing an object itself to recognizing it clearly in a picture. 
Questions as to relative sizes of pictured objects may 
also lead to interesting discoveries. 1 

M. Language. — It is the power of language which 
distinguishes man from the animals. A sufficient mas- 
tery of the elements of spoken language is therefore 
requisite to make rational human development possible. 
Substitutes for spoken language never reach the accu- 
racy of the live word. Thought is bound up with lan- 
guage and is clarified by expression through language. 2 
Written language, on the other hand, is the result mostly 
of school training, and there are persons unable to read 
or write who nevertheless possess a respectable amount 
of intelligence and social effectiveness. Illiteracy as 
such is not necessarily a defect; it may be an accident. 
Furthermore, there are some persons who may never, 
from constitutional defect, develop high qualities in the 
province of book-lore and written expression, and yet be 
perfectly able to contribute a considerable efficiency 
increment to society through other gifts — of an artistic, 
constructive, or other kind. We may bear in mind the 
fact that the human race had existed for many genera- 
tions and had built up civilization after civilization be- 
fore the arts of reading and writing became privileges of 
the masses. 3 There are to this day civilization levels 
in modern society which represent these earlier stages. 
They will be found "backward" in the traditional "es- 

1 Cf. "The Career of the Child," pp. 82/. 

" Cf. "The Career of the Child," chap. XII. 3 Cf. Chapter III. 



326 THE EXCEPTIONAL CHILD 

sentials" of the ordinary school, reading, writing, and 
even arithmetic, and yet are not mental defectives in the 
true sense of this term. They fill their place in life. 

The results of the language tests here presented must 
be measured in the spirit of the foregoing considerations. 

Story Told from Picture. — The first test requires the 
telling of the story which a picture suggests. Any pic- 
ture representing simple action, illustrations of fairy- 
tales, and the like, may be used. The step from merely 
enumerating the objects seen in the picture, as in the 
foregoing test, to the description of its elements, and 
the further steps to the valuation of the situation the 
picture represents, and to the interpretation of the pic- 
ture's message to the observer, are important. 

This first test is an oral one, appealing to spoken 
language only. 

Written Reproductions. — The second test is threefold. 
It refers to the reproduction of a story which is either 
told the child, or read by him, or which he remembers, 
in writing. This test differs from the auditory memory 
test in this that it demands more than a mere reitera- 
tion or enumeration of memory images which are 
counted singly. It refers to the ability of the child to 
catch the spirit of a story and to tell the story as such 
intelligently in words of his own. The writing of it 
amounts really to a composition, and the author has 
therefore included this test in his minimum require- 
ments, omitting the writing of an original composition 
as mentioned under O, 4. The three forms in which 
this test is presented embody three different methods 
of performing it. 

In cases of illiteracy an oral reproduction may be sub- 
stituted for the written one. After all, this is a language 



SCHEDULE OF TESTS 327 

test, not a literacy test, excepting in the case of the 
second form, which requires the reading of the story. 

Completion Test. — Test 3 presents a set of fifty-six 
incomplete sentences to be completed by the child. He 
is to write on each line of dots the word which makes 
the best meaning. The sentences are graded with a 
view to increasing the difficulty with each step. While 
this test will gauge the ability of the child to use correct 
language, it is also a judgment test of high value, as it 
requires considerable discernment to catch the meaning 
of the sentence from which important elements are 
omitted. 

This test was suggested by M. R. Trabue, of Colum- 
bia University, working with Professor E. L. Thorn- 
dike. Their investigations as to the best graded set 
were not completed at the time of this writing. 1 The 
set used now is as follows: 2 



Name: . . . 
Date: 



ON EACH LINE OF DOTS, WRITE THE WORD WHICH MAKES THE BEST MEANING. 

i. We like good boys (and) girls. 

2. The sky (is) blue. 

3. I see (the) man and the boy. 

4. We are going (to) school. 

5. Men (are) older than boys. 

6. The (dog) is barking at the cat. 

7. The kind lady (gave) the poor man a dollar. ' 

8. The stars and the (moon) will shine to-night. 

9. Here is the man who (can) do it. 

10. The bird (sings) a song every morning. 

11. The (girl) plays (with) her dolls all day. 

12. Good boys (are) kind (to) their sisters. 

13. Boys must (not) be rude to (their) mothers. 

'Just before the manuscript of this book went to press the author 
received the announcement of the publication of Mr. Trabue's inves- 
tigation by the Teachers College. 

2 The correct insertions are enclosed in parentheses. In the sheet 
given to the child, dots represent the missing word. 



328 THE EXCEPTIONAL CHILD 

14. When the (boy) grows older he (will) be a man. 

15. The stars (shine) brightly at (night). 

16. The boy will (burn) his hand if (he) plays with fire. 

17. The wind (blows) the dust into our eyes. 

18. The best (time) to sleep is at night. 

19. The girl fell and (hurt) her head. 

20. The little (boy) and his dog (are) running a race. 

21. The rude child does not (have) many friends. 

22. Time (is) often more valuable (than) money. 

23. The poor baby (cries) as if it were (very) sick. 

24. The (sun) rises (in) the morning and (sets) at night. 

25. The child (fell) (into) the river (and) was drowned. 

26. Boys who play (in) (the) mud get their hands (dirty). 

27. It is good to hear (the) voice (of) (a) friend. 

28. The poor little (boy) has (had) nothing to (eat); he is hungry. 

29. Boys and (girls) soon become (men) and women. 

30. The boy who (tries) hard (will) do well. 

31. She (can) if she will. 

32. One's (words) do (not) always express one's thoughts. 

33. Very few people (know) how to spend time and (money) to the best advan- 

tage. 

34. It is a (hard) task to be kind to every beggar (who) (asks) for money. 

35. Brothers and sisters (should) always (try) to help (each) other and should 

(never) quarrel. 

36. Worry (has) never improved a situation but has (often) made conditions 

(, worse). 

37. Men (are) more (fitted) to do heavy work (than) women. 

38. (Fair) weather usually (has) a good effect (on) one's spirits. 

39. If a person injures one by (accident), without having intended any (harm), 

one should (not) (feel) insulted. 

40. A shelter (against) the weather is (much) appreciated on a (stormy) day. 

41. It is very (difficult) to become (well) acquainted (with) persons who (are) 

timid. 

42. The best advice (can) usually (be) obtained (from) one's parents. 

43. A home is (not) merely a place (where) one (can) live comfortably. 

44. The sun is so (bright) that one cannot (look) (into) (it) directly (without) 

causing great discomfort to the eyes. 

45. To (begin) many things (without) ever finishing any of them (is) a (bad) 

habit. 

46. (There) are times in the (lives) of almost (all) of us when we (hope) for a 

long life. 

47. Children should (remember) that after all nobody is (apt) to care much 

more (for) their success than (their) (own) parents. 

48. One's real (character) appears (more) often in one's (deeds) than in one's 

speech. 

49. It is very annoying to (have) (a) toothache (which) often comes at the 

most (inconvenient) time imaginable. 

50. When two persons (talk) about (things) which neither understands, they 

(are) almost (certain) to disagree. 

51. (Few) things are (more) satisfying to an ordinary (man) than congenial 

friends. 



SCHEDULE OF TESTS 329 

52. When one feels drowsy and (tired), it (often) happens that he is (unable) 

to fix his attention very successfully (upon) anything. 

53. The knowledge of (how) (to) use fire is (one) of (the) important things 

known by (man) but unknown by animals. 

54. To (retain) friends is always (worth) the (effort) it takes. 

55. (Injuries) that are (done) to one by an (angry) friend should be pardoned 

(more) readily than injuries done by one (who) is not angry. 

56. One ought to (take) great care to (develop) the right (kind) of (habits), 

for one who (has) bad habits (finds) it (difficult) to get away from them. 

Other words than those here suggested may be in- 
serted without detriment to the meaning of the sen- 
tence, in some cases. Children will sometimes display 
rather original conceptions of a situation, and we must 
take them on their own terms. 

The manner in which subjects respond to this test 
allows most interesting conclusions in regard to their 
mentality and the effect of their schooling. Their indi- 
vidual experience and personal equation count to some 
extent. 

Ciphers; Puzzles; Secret Languages. — Lindsay, in the 
American Journal of Psychology, VIII, 4, has made a 
most interesting study of puzzles in child education; and 
Chrisman has contributed a valuable investigation of 
secret languages and the part they play in the language 
development of the child, in the Child Study Monthly of 
September, 1896. A further discussion of these impor- 
tant subjects will be found in chapters V and XII of 
the author's book, "The Career of the Child." His 
own practical work with children has convinced him of 
the enormous significance puzzles and secret languages 
have for the mental training and the evolution of the 
child mind, especially with regard to clear-cut concep- 
tions of words and their meaning, of thought relations, 
and of precise cognition generally. 

These considerations have induced him to insert the 
reading of ciphers into this schedule of tests. The ar- 



330 THE EXCEPTIONAL CHILD 

rangement given here, under (4), offers three forms in 
an ascending scale of difficulty. Even the first, the 
Rearrangement of Words to make sense, requires an 
amount of mental effort and judgment which would 
distinguish the potentially normal child from the defec- 
tive. The following cipher is used: 

sent mother to last baker my 

the some me bread to night buy. 

(My mother sent me to the baker last night to buy some 
bread; or, Last night my mother sent me to the baker to buy 
some bread.) 

The American version of the Binet series offers for 
the "mental age" of 12 the following three sentences: 

1. For an the at hour early we 

country started. 

2. To asked exercise my I teacher 

correct — — my. 

3. A defends dog good his master 

bravely. 

Huey transfers this test to the eleventh year and 
gives a slightly different arrangement of the words: 

1. For The Started An We Country 

Early At Hour. 

2. To Asked Exercise My Teacher 

Correct My I. 

3. A Defends Dog Good His Bravely 

Master. 



The reasons for these changes seem obvious. Other 
examiners have substituted other sentences which they 
believed were more within the range of their subjects' 
experience. 



SCHEDULE OF TESTS 331 

It is plain that this test is considered even by Binet 
one which requires at least pubescent maturity of rea- 
soning power, even though Huey places it one step lower 
in the "mental age" scale. The author's own sentence 
contains almost twice as many words as those of the 
Binet scale and may seem therefore more difficult. It 
has not always been found so in practice, as it covers a 
simple situation. But he has accepted, from younger 
children, a partial solution of the cipher — if they get 
some sense out of it, even though they do not use all 
the words. Some of the forms so accepted are: "My 
mother sent me to buy bread last night." And: "Some 
baker sent my mother bread last night." If other ex- 
aminers would prefer to introduce the Binet series as 
preparatory to the sentence here given, it would not 
change the nature of the test. 

The Cipher of the Second Order is represented by the 
use of either numbers or letters. The simplest number 
cipher gives to each letter its corresponding number: 
i = a, 2 = b, 3 = c, etc. There may be an arbitrary ar- 
rangement, as,/, i., numbering first the vowels a, e, i, o, 
u, and y as i to 6 respectively, and then the consonants 
in a similar manner: 7 = b, 8 = c, 9 = d, 10 =/, etc. 
In using letters for letters we may choose the next fol- 
lowing letter to represent the preceding one, as b = a, 
c = b, etc., or devise some other arrangement. In our 
short examination we use this method only, asking the 
subject to decipher the following: 

Nz gbuifs mpwft nf = My father loves me. 

To subjects who have no experience in ciphers a sim- 
ple explanation will have to precede the test. 



332 



THE EXCEPTIONAL CHILD 



For the Third Order the one suggested by Huey, and 
originally by Healy, is used, as described in " Backward 
and Feeble-Minded Children," page 198, and suggested 
by Huey for the "mentality of 15 years." It is as 
follows : 



A 


B 


C 


D 


E 


F 


G 


H 


1 



J. 


K # 


,L 


M. 


N . 


.0 


P* 


Q* 


*R 





vj r= 



WAR 



Fig. 17. 
Cipher of the third order. 

Tests 5 and 6 again combine language efficiency or, 
rather, a command of words, with the power of judg- 
ment. 

Opposites. — Test 5 calls for the opposites of the fol- 
lowing list of words: Bad, short, little, poor, well, thick, 
full, few, slow, soft, dark, sad, true, equal, sorry, new, 
cold, smooth, clean, deep, narrow, stale, heavy, high, 
bitter, living, open, kind, peaceful, lazy, quiet, above, 
within, near, master, friend, to love, to sleep, to sit, to 
work. 

Classification. — First, a list of qualities is offered: 

Name something that is high — cold — smooth — red — 
round — clean — bitter — heavy — soft — new — yellow — 
bent — wooden — glass — deep — empty — narrow — loose 
sour — level — fresh . 

Secondly, a list of activities: 

Name something or somebody that walks — flies — 
barks — rolls — marches — teaches — swims — rides — sings 
— learns — rises — sinks — bumps — jumps — counts — floats 
— earns — spends — pays — sells — sails — buys. 



SCHEDULE OF TESTS 333 

Thirdly, the following two sets of categories: 

(a) Name an animal, a plant, a food, an article of 
clothing, a piece of furniture; — a form of land, an occu- 
pation, a kind of building, an exercise, a game; — a virtue, 
a state of mind, a state of body, a purpose, an ideal. 

(b) Of what is a part: a drawer, an arm, a sleeve, a 
seam, a leaf; — a room, a signature, a handle, a wall; — a 
soldier, a title, a teacher, a paragraph, a sailor, a word ? 

It will be observed that each of these series is arranged 
in an ascending order of difficulty. A signal or absolute 
failure to give opposites or classifications throws a child 
out of the group of potentially normal. But different 
degrees of maturity can easily be detected by the an- 
swers given. Of course the elements of personal ex- 
perience and of school training play their part, but it 
will have to be decided by the examiner whether these 
are merely mechanical in nature or coupled with native 
ability of discernment. Even a child of the primary 
group will give at least one-fourth of the forty opposites, 
one-third of the twenty-one qualities, and as many of 
the activities. Perhaps the categories are beyond his 
stage, except the first group of five of set (a). But we 
need much more experience to "standardize" in any 
way. We can draw more important conclusions from 
the quality than from the number of answers given. 
What we are more interested in than even the present 
status of the subject is his chance of development, i. e., 
his growth qualities. These can be deduced from the 
quality of his thought in giving these answers. 

Where school training has been superficial, so that 
the child does not readily understand the terminology, 
e. g., does not readily know what is meant by "oppo- 
sites," preliminary explanations and illustrations must 



334 THE EXCEPTIONAL CHILD 

be given. The fact should be stated in the record. 
With immigrant children, we shall have to valuate their 
possible foreign language handicap. 

N. Reading. — Here are to be recorded: (i) The 
grade a subject has reached, most easily expressed in 
stating the number of the reader (in a graded series) 
which he can easily master; (2) his reading facility; (3) 
his expression; (4) his enunciation and articulation (even- 
tually revealing speech defects) ; and (5) the understand- 
ing of the text read he exhibits. This understanding 
will manifest itself, in a measure, in the manner in which 
he handles the text in reading. A few leading questions 
as to what he has been reading about will assist in de- 
termining the degree of his intelligent mastery of the 
selection. This test may be connected with language 
test 2, and the same selection may be used for written 
(or oral) reproduction. 

For a better valuation of this test it may be well to 
read chapter XIII, "Reading and Literature, with Re- 
marks on Method," in . the author's "Career of the 
Child." For both the reading and the writing tests, cf. 
Miiller's investigations as referred to on pages 144 jf. of 
this book. 

0. Writing. — Referring to what has been said before 
on the significance, or lack of significance, of literacy 
and illiteracy, the writing tests are here introduced for 
what they are worth. They are intended to determine 
what may be styled the writing equipment of the sub- 
ject. 

That a person's first accomplishment after learning 
to write is to write his own name, is recognized in the 
first of the writing tests here suggested. 



SCHEDULE OF TESTS 335 

The second test is copying from a reader. While it 
would seem natural to give the child a selection from a 
reader of the same grade that he can read in, he may in 
actuality show greater or inferior proficiency in copy- 
ing than in reading, the two arts being physiologi- 
cally and psychologically different. The fact should 
be noted. 

The spelling test (dictation, 3) is in a measure a mem- 
ory test. This memory may have a visual, or an aural, 
or a motor quality. Only as a motor test is it, strictly 
speaking, a test in writing. The preceding tests of 
visual and auditory memory will assist the examiner in 
determining the memory quality of the spelling test, 
unless he wishes to enlarge upon this test in a special 
way. It is, of course, of importance to know, in the 
interest of the future training of the child, whether he 
is "ear-minded," "eye-minded," or "motor-minded." 
But here it is of especial interest to study the child's 
method of spelling, whether it is phonetic (which would 
suggest the auditory element), or whether there are in- 
versions while otherwise the right number of right let- 
ters is given (which would suggest " eye-mindedness " 
with inaccuracy of impression or inadequate visual 
memory), or omissions, or other peculiarities. 

Test 4, composition, has been included under writ- 
ing, although it is really a language test, for the reason 
that it is the intention here to test the child's ability to 
express himself in writing. It is well to recall what has 
been said in this regard under M, 2. The reader is also 
invited to read chapter XIV of the "Career of the 
Child," on "Oral and Written Composition." 1 

1 It may be of interest to compare with the requirements of these 
tests the "Tentative Minimum Requirements in English for Graduation 



336 THE EXCEPTIONAL CHILD 

P. Number Concept. — The principles underlying 
these tests will be better appreciated after reading 
chapter VIII in "The Career of the Child," on the 
"Mathematical Evolution of the Child." It is shown 
there that the child's number concepts are of twofold 

from an Elementary School," as suggested by a committee of the Bos- 
ton Public Schools: 

i . To copy twelve lines of simple prose or poetry, and a bill of at least seven 
items. 

2. To take down from dictation a passage of simple prose. 

3. To write from simple directions a friendly letter or an application for a 
position. 

4. To write within a half-hour a simple, original composition of not less than 
one page of letter paper, with every sentence grammatically complete. The pu- 
pil may make revisions, including interlinear corrections, but must not rewrite. 

5. To recognize the parts of speech in their common uses; to explain the 
construction of words and phrases in a simple sentence containing not more 
than one phrase modifier in the subject and one phrase modifier in the predi- 
cate; to have a practical understanding of the uses to which the dependent 
clause of a complex sentence can be put — whether it be to serve as noun, adjec- 
tive, or adverb; to know the principal parts of regular verbs and of the common 
irregular verbs, and their tense forms through the indicative mood. 

6. To read at sight with readiness and good expression simple prose as diffi- 
cult as '"Little Men" or "Hans Brinker." 

7. To quote either orally or in writing fifty lines, not necessarily consecutive, 
of classic prose or poetry. 

8. To stand before the class and talk clearly on some subject of personal, 
school, or public interest. 

With the exception of requirements 5 and 8, the points here sug- 
gested are covered by our schedule of tests. However, wide limits must 
be allowed. 

Actual tests made with these empirically set up standards, as reported 
by Ballou, revealed that some pupils made as many as forty or fifty 
mistakes in copying fifteen lines of simple prose, and that very few pupils 
made less than half a dozen mistakes. Again, very few of the six thou- 
sand children tested remembered much that they were able to write in 
an intelligent manner. Since it is so, says Doctor Ballou, it becomes 
necessary to decide certain important matters. Considering the fact 
that some of these pupils undoubtedly did know fifty lines of classic 
prose or poetry at one time, was it worth while teaching it to them if 
they have so soon forgotten it? Again, should they be expected to 
remember it for a longer time than most of them did? Also, if children 
are going to forget so soon much memory work, is it of sufficient impor- 
tance to set up a standard for it ? 

This argument is very illuminating, indeed. 



SCHEDULE OF TESTS 337 

origin: being the result, on the one hand, of a continuous 
series (counting), and of space conceptions on the other. 
In chapter V, "A Rational Course of Study," mention 
is made of a distinct "counting period" in the mental 
development of the child, a period which precedes the 
conception of number as an entity, or of cardinal number 
in distinction from ordinal number. As long as a child 
merely counts he has not the concept of cardinality, 
and will confuse number proper with place in a certain 
series. In other words, a child is apt to attach the name 
"five" to the "fifth" object, not to the entire quantity 
of five units. 

In the counting test, special attention must be given 
by the examiner to the facility with which a child passes 
from 19 to 20 and 21; from 29 to 30, and so on. Again, 
from 99 to 100 and 101; from 199 to 200; from 999 to 
1,000, etc. It would, of course, extend the time of the 
test unduly were the child made to count all the way 
up. A commendable practice is this: Let the child count 
only part of the series, jumping from 34, for instance, 
to 95; from in to 156, with similar ellipses all along 
the line. This will not only ascertain a child's counting 
facility with sufficient accuracy, but also his power 
of quick adjustment. 

Counting backward is really a continued subtraction of 
the same number and will be found much more difficult 
than counting upward. Even Binet, who claims to 
avoid tests presupposing school training, includes the 
counting backward from 20 in his 8-year test. He 
wants the child to count to o, while the author agrees 
with Huey, who makes 1 the downward limit. Fluency 
in the downward range is a good sign of clear operation 
with numbers. Again, attention must be given to the 



338 THE EXCEPTIONAL CHILD 

passing from higher to lower tens (91, 90, 89 — 81, 80, 79, 
etc.). Many children are apt to count like this: 92, 91, 
80, 89, etc. 

Counting by twos, tens, fives, and threes may seem to 
depend mainly upon facility in the multiplication table, 
and thus depend upon a mastery of these, which is 
largely a mechanical-memory process — the "making of 
certain noises in a certain sequence," as a witty English 
critic of faulty school methods has expressed it. As a 
matter of fact, however, unless the tables have been 
taught that way in school, this test represents a task to 
the child which requires a clearer number concept, of 
the serial principle at least, than ordinary counting. It 
requires the conscious omission of regular elements of 
the ordinary series. Counting backward by twos, tens, 
fives, and threes is peculiarly apt to reveal a child's 
facility in this respect. What has been said before 
about elliptical counting applies to counting by twos, 
tens, etc. 

In constructing numbers on the abacus it is essential to 
induce the child to move 3, 5, or more beads A T ONCE, 
without counting. It is a test in number concept, in 
grasping a quantity as a whole. This test becomes even 
more interesting when a child is asked to construct a 
number which requires using beads from several rows, 
as 15, 23, 47, etc., when it will become quite evident to 
the observer whether the child grasps the situation 
offered by the abacus promptly, or not. 

Numbers like 15 or 21 may also be constructed by 
requiring the child to use the same numbers of beads 
in 3 different rows, introducing multiplication and 
division. This test is intimately related to the primi- 
tive counting-board work, still employed by the Jap- 



SCHEDULE OF TESTS 339 

anese, Chinese, etc. Also, it tests the actual number 
concept of the child. 

The adding game with dice adds the feature of con- 
ventional arrangement of units in groups. In this man- 
ner much higher numbers can be quickly recognized 
than when the units are arranged in rows, as on the 
apacus. Use one, two, three, and more dice. 

Many ordinary children's games involve adding and 
subtracting of simple numbers. In the last test of this 
series an inexpensive top-spinning game is used, some- 
what like a roulette, bought at the toy store. Wherever 
the top lands there is a number to be added or sub- 
tracted to the sum previously obtained. The game 
presents the numbers from 5 to 50, in differences of 
five. 

Space Conceptions. — Tests 2 and 3 introduce the 
other source of number conception— space. The first 
test is the most elementary one of all — the comparison 
of a small bundle of kindergarten sticks (three) with a 
larger bundle, containing four times as many (twelve). 
Such a comparison is the first step a young child takes 
in the realization of number differences. These differ- 
ences are represented by differences in size. With very 
young children the tests will fail unless the sticks have 
the added attraction of color, or are made of candy. It 
indicates, of course, a low degree of number conception 
if this test fails with older children. 

Test 3 is made with a number of sticks varying 
in length from one inch to twelve inches. The first 
question asked is: "Which is the shortest stick?" The 
second, " Which is the longest?" The child is then 
asked to build up the length of the longest by using 
shorter sticks, beginning with the shortest. It may be 



340 THE EXCEPTIONAL CHILD 

found that some children will do this task well who 
cannot recognize number otherwise. Their good and 
fundamental idea of form and space may then be made 
the starting-point in instruction to develop the number 
concept. Comparison of different lengths and sizes leads 
up to quantitative concepts. The test may be varied 
in different ways. 

Courtis Tests. — Test 4 introduces the "Courtis Tests." 
These have been recently so widely employed in measur- 
ing the efficiency of class work in schools that it is 
unnecessary to describe them here. But their appli- 
cation in this series of tests rests upon their adapta- 
bility to the testing of individual children. How this 
can be done has been instructively illustrated by the 
Department of Educational Investigation and Mea- 
surement of the Boston public schools. In explaining 
the work of the department in this direction Miss Rose 
A. Carrigan writes in Bulletin II: 

To make sure that his ability is of a reasonably permanent 
nature, the pupil should measure up to the grade standard on 
at least three successive occasions. Whereas a single test of a 
thousand or more children is adequate to demonstrate the effi- 
ciency of the teaching process in general, one test is not sufficient 
to determine the ability of the individual. To do this last 
effectively, several tests are necessary; otherwise there is dan- 
ger of incorrect conclusions resulting from chance scores. 

This very correct statement shows the serious limita- 
tion of clinical study which is confined to one observation 
or test. Nevertheless, taken in connection with the 
other tests, one examination of a child in the addition, 
subtraction, multiplication, and division examples given 
in Series B, Arithmetic, of the Courtis Standard Re- 
search Tests will allow of helpful conclusions. The re- 



SCHEDULE OF TESTS 



341 



suits should be compared for valuation with the age and 
grade standards worked out by Mr. S. A. Courtis, De- 
troit, Mich., with such elasticity of application as will 
adjust them to individual types of mind. 

Doctor Frank A. Ballou, director of the Boston de- 
partment, has kindly given permission to use the fol- 
lowing individual scores as illustrations of the value of 
this method for individual testing: 



1 

GRADES 


6 7 J 


No. of Examples 


9 


10 


11 


12 


13 


14 


,49" 


16 


17 


18 


19 


20 


21 


22 


23 


24 


TEST1 

(Attempts 
ADD. 

' Rights 
TEST 2 

(Attempts 
SUBT. 

t Rights 
TESTS 

f Attempts 
MULT.J 

( Sights 
TE6T1 

(.Attempts 
DIV.i 

( Rights 
































































S 

























.-- 




'" 
























! 
































.-"*' 


















/ 


' 










l 




















% 


^ 










s 


\ 




















/ 


? 



























































Fig. i 8. Chart I. 



Case 68. — Fig. 18 represents the curve of a 12-year- 
old boy in the eighth grade of a Boston school. The 
solid line represents the standard for his grade, the 
dotted line his score. It will be seen immediately how 
far he left the standard, or average, behind in amount 
of work done, and in accuracy. He did practically 
double the work of the average and exceeded the stand- 
ard of accuracy three times, solving all examples he at- 
tempted in subtraction, multiplication, and division. 

Case 69. — Fig. 19 shows the record of another 12- 
year-old boy, in a seventh grade at Edgerton, Wis. 
In the number of rights he is ahead of the standard at 



342 



THE EXCEPTIONAL CHILD 



GRADES 


4 5 6^8 


No. of Examples] 


1 


2 


3 


4 


5 


6 


7 


8 


9 


10 


n 


i2-; 'fj 


14 


IS 


16 


17 


IS 


19 


TEST1 

(Attempts 

ADD,- 

{ Rights 

TEST 2 

(Attempts 
SUBTC 

I Bights 
TESTS 

* Attempts 
MULT) 

( Rights 

TEST 4 

* Attempts 

DIV.J 

( Rights 




















_^-^l 


















































































































: 




































r~> 




































i 












































































• 



























































Fig. 19. Chart II. 

all points, and his curve is more nearly a straight line 
than the average. 

Case 70. — Fig. 20 is remarkable for two reasons. It 
represents the work of an eighth-grade Boston girl of 



GRADES 


6 7 JL 


No. of Examples 


9 


10 


11 


12 


13 


14 


^15^ 


16 


17 


: tr" 


k 19 ^ 


.20 


21 


22 


23 


24 


TEST1 

/■Attempts 
ADD.] 

( Rights 

TEST 2 

( Attempts 
SUBT.! 

{ Rights 

'TEST 3 

(Attempts 
MULT.J 

I Rights 

TEST 4 

(Attempts 
DIV.J 

I Rights 






















"s. 








































1 


















p _-- 


-- 


;^J 






— " 






















1 
1 
































/"" 
























/ 






1 
























^ 


\ 












___ 




















/ 


> 








: 




1 















































Fig. 20. Chart III. 

13, who had not been thought to be in any way dif- 
ferent from the average. Here the broken line repre- 
sents her score in January, 1914; the dotted line the 
score three months later, in April. In both she is con- 
siderably ahead of the average standard in everything 



SCHEDULE OF TESTS 



343 



except multiplication, where she is closer to the average. 
But in the three months, perhaps just because she 
thought that she was "good in arithmetic, anyway," she 
lost in amount and somewhat in accuracy, except again 
in multiplication, where her lower score had apparently 
prompted her to make some effort. This shows the 
value of practice, even in things which are otherwise 
well mastered. 

Case 71. — This value of practice is clearly proven by 
Fig. 21, exhibiting the January and April scores of an 
11-year-old Boston girl in the fifth grade. At the first 
trial the pupil was below standard in addition and sub- 



GRADES 


* A*.^ * 7 8 


No.. of Examples 


1 


2 


i 


4 


5,- 


-% 


7 


\>- 


•-9 


10 


11 


12 


13 


14 


15 


16 


17 


18 


19 


TEST 1 

( Attempts 
ADO.] 

1 Rights 
TEST 2 

f Attempts 
SUBT? 

( Rights 

TESTS 

c Attempts 
MULT.' 

( JUghts 

TEST 4 








> 


.' 


































' 
















1 
• 



































































-' 






/ 


• 


























< 


^ 










































i> 


^» 
































/ 


/N 


\ 




























DIV.5 

t Rights 








v 


^ 


** 


/ 


r /* 































































Fig. 21. Chart IV. 

traction. After three months of practice she surpassed 
the standard in all four of the fundamental operations. 
The greatest improvement was in addition, which was 
the operation in which she had least ability at the time 
of the first test. 

Case 72. — Chart V exhibits the eradication of a par- 
ticular weakness (in multiplication) in a 10-y ear-old 
Boston girl pupil of the fifth grade, with a corresponding 
loss in her former best operation (subtraction). Her 



344 



THE EXCEPTIONAL CHILD 



score in April is more nearly like the standard, but more 
even than the average. 

These examples give sufficient evidence of the need 
of individual valuation and of attention to individual 



GRADES 


4 5 6 7 8 


No. of ExampUs 


1 


2 


i 


4 


5 


6 


fi 


-8 


9 


10 


11 


12 


13 


14 


15 


16 


17 


18 


19 


TEST1 

c Attempts 
ADD.J 

( Rights 

TEST 2 

, Attempts 

SUBT.5 

( Rights 
TEST 3 

# Attempts 

mult.} 

( Rights 
TEST 4 

, AttemptB 
0IV.5 

( Rights 












/ 




































t 

• 


I 




















































































1 
1 






























-+- 







































i 


































— . 








































d 


s^ 




l 

































































Fig. 22. Chart V. 

needs. To show how very necessary individual stand- 
ards are, how false ordinary school standards, and how 
much we are laboring under misconceptions in regard 
to the value of arithmetical drill as at present conducted 
in our schools, the author will permit himself to quote 
again from Doctor Ballou's paper: 

The Courtis Tests have revealed great variations in the abil- 
ity of pupils to add, subtract, multiply, and divide. They have 
shown that we have at the present time practically all grades of 
ability, from the fourth to the eighth in each class tested. 
Twenty-nine per cent of the pupils in the eighth grade could 
exchange places with a like number of pupils in the fourth 
grade without changing in the slightest the arithmetical ability 
in the fundamental operations of either class as a class. 

The tests also show that from 35 to 50 per cent of the children 
tested in any one grade did not increase their ability at all in 
addition, subtraction, multiplication and division from the time 
the tests were given in January until they were given in April 



SCHEDULE OF TESTS 345 

— a period of about three months. This means that the chil- 
dren in these grades have apparently not profited in the least 
by the instruction given. For example, in the eighth grade in 
division, 32 per cent of the children tested showed no increase 
in ability to solve problems correctly. Also, in the fourth grade 
50 per cent of the children tested showed no increased ability 
whatever in division, although that is the particular topic of 
instruction in arithmetic in the fourth grade. 

What is the reason for these conditions? It seems probable 
that the drill work in the fundamentals carried on at the present 
time is not adapted to all pupils. In fact, it is probable that 
there is no one drill that is equally well adapted to any consider- 
able number of pupils. Some pupils who do profit by a drill 
get more than they need under present conditions, while those 
who do not profit are merely marking time, or, as is shown by 
these tests, are actually declining in ability. This means that 
by class drills the variations in ability among pupils are being 
constantly increased rather than decreased. 

Isn't it about time to recognize these variations in 
our methods of school instruction, and in our valuations 
of individual scores? 

Problem in Judgment. — Test 5 is a particular problem 
in judgment. It may also be considered a problem in 
the power of visualization. It may be presented in 
various forms. One is given on page 296. Another 
form would be as follows: 

You have seen boys march one behind the other, in 
single file, have you not ? Now, there was a little line of 
boys marching down the street one day, playing soldiers. 
How many do you think they were? There were two 
marching in front of one, one was in the middle, and 
two were marching behind one. How many altogether ? 

As the catch, if it may be so considered, is in the con- 
dition of marching in single file, and as it is not intended 
to emphasize this source of error, the examiner may 



346 THE EXCEPTIONAL CHILD 

repeat to the child several times that the boys were 
marching one by one. The proper answer is, of course, 
three boys. But the first hasty answer will usually be, 
five. Even the numbers seven and six have been offered. 

If the child fails to visualize we may give him a sec- 
ond chance to use his judgment, by drawing dots on a 
piece of paper, or using the peg-board, or the abacus, 
to illustrate the line of boys. The examiner may, in 
extreme cases, even go so far as to say: If there were 
five boys, you would have four in front of one, etc. If 
even this suggestion, combined with the visual repre- 
sentation of the boys by the use of dots, pegs, or beads, 
fails to bring out the true situation, the child's concep- 
tual ability proves itself to be of low order. 

Further Puzzles. — Tests 6 and 7 are again in the na- 
ture of puzzles and usually arouse intense interest in 
potentially normal children. In the Magic Square the 
digits from 1 to 8 are represented by capitals, thus: 

ABC 
D E 

F G H 

The problem is to arrange the figures so that A + B -f 
C = A+D + F = C + E + H = F + G + H = i5. 

There are several solutions possible. One is this: 

6 1 8 

2 4 

7 5 3 

Test 7 has been suggested by J. H. Doyle, lately of 
the Culver Military Academy. It consists of four mul- 
tiplication examples, in which certain numbers are rep- 



SCHEDULE OF TESTS 347 

resented by letters for which the proper figures must be 
substituted. They look as follows: 

A LM KR T 4 

X3 X3 X6 XN 



iA 18L 1R8 3N6 

The solutions are: A = 5; L = 6; M = 2; K = 2; 
R = 3; T = 4 ; N = 9. 

Q. Discrimination. — The tests in discrimination pre- 
sent some further features in testing the power of judg- 
ment and common sense. 

Matching Pictures. — Test 1 is a primary test and de- 
mands of the child the sorting of picture postals rep- 
resenting city streets and scenes, or flowers and fruits, 
mounted on cardboard for easier and safer handling. 
There are twelve different pictures, and each one is in 
duplicate. The child is asked to find the duplicate of 
each. The test may be extended and varied by en- 
larging the number of pictures and increasing the diffi- 
culty of identification. Note the method of search. 
Some children will waste time by looking through the 
whole pile to find the mate of one card, instead of imme- 
diately arranging all cards for handy reference in du- 
plication. 

Comparing Lines. — Test 2 is the well-known Binet 
Test. In the Binet series it is placed in the group for 
the "mental age" of 12. It is fully described in every 
Binet syllabus. 

Picture Arrangement. — Test 3 has been suggested by 
Professor D. Kennedy Fraser, of Cornell University. 
His full description, together with a series of fifteen sets 



348 THE EXCEPTIONAL CHILD 

of pictures can be obtained by addressing him at the 
University, Ithaca, N. Y. The idea is to put before the 
child a set of detached pictures which in their proper 
order tell a story. They are presented in disarrange- 
ment, and it is the subject's task to study the intention 
of the story so as to find the proper sequence of the pic- 
tures. Doctor Fraser has selected sets from the well- 
known "Foxy Grandpa" books because these pictures 
have no writing on them and tell their own story, even 
after removing the explanatory text, which is printed 
underneath. 

Doctor Fraser is making his experiments with these 
sets in order to standardize them in the usual way. He 
therefore presents the pictures in certain definite plans 
of disarrangement. From what is said in the chapter 
on the function of the educational clinic it will be evi- 
dent that our purpose is different. While we may con- 
tribute to the experimental material for laboratory use, 
our main object is to test the power of discrimination 
in an individual child. Can he grasp the situation? 
Can he see the proper sequence? It will be well to 
arrange these sets, as Fraser does, according to their 
relative difficulty. But even here we may expose our- 
selves to erroneous conceptions and miscalculations. 
Fraser has been making his tests on adults. But an 
adult's point of view often differs materially from that 
of a child, especially if the adult is a college student. A 
child may grasp a Foxy Grandpa situation much more 
readily than an adult of intelligence and education, be- 
cause it is nearer to a child's fine of experience and 
thinking. 

The author is, therefore, using any suitable series of 
from six to ten pictures, presented in chance order, sim- 



SCHEDULE OF TESTS 349 

ply introducing the task somewhat in the way Professor 
Fraser suggests, explaining to the subject the general 
idea of the test and the purpose of the story. Although' 
the timing feature has its value, it need not be empha- 
sized. Credit ought to be given for partial solutions 
of the problem. 

Illusions. — Test 4 introduces two illusion tests. The 
illusion is normal. The meaning of these tests is de- 
scribed and explained in the author's book, "Some 
Fundamental Verities in Education," pp. 25 Jf. 

For Test (a) two pieces of wood are used, each weigh- 
ing one pound. One is just an ordinary piece, 2x4 
inches, about 1 foot long. Another 2x4 piece is cut, 
but only about 3 inches long. This short piece is sawed 
apart, hollowed out and filled with lead, so that the 
whole piece, when glued together again, would weigh 
exactly as much as the larger piece. The seams should 
be carefully obliterated and the pieces varnished, so as 
to enhance the illusion. The smaller piece will be 
thought to be heavier. It has been claimed that all 
children of 8 or more years get the illusion. 1 

The Optical Illusions (b) are taken from James, 
"Psychology," II, 232 jf. A simple optical illusion is 
the comparison of a white circle on a black background, 
with a black one on a white background. Both are one 
inch in diameter. The white circle will appear larger 
than the black one. 

R. Construction. — Under the general heading of 

"construction" the author has assembled a selection of 

tests which involve conception of form and relationship, of 

geometric design and rational construction of some kind. 

1 This is the Demoor Size-Weight Illusion. 



350 THE EXCEPTIONAL CHILD 

Form Boards. — First, the form boards are intro- 
duced. 

Under (a) we present the familiar Seguin Form Board 
(Goddard style), offering ten insets. It will be noticed 
that there is a distinct mental difference between those 
children who succeed, if they do at all, only after me- 
chanically trying to fit the insets into any groove at 
all, without considering form, and striking the right 
one by chance; and those who rationally compare the 
form of the inset with the form of the groove. In this 
form board each form is different, and no inset can be 
fitted into any other groove but its own. The children 
who work rationally also work the quickest. 

Investigations at Vineland seem to show that this 
test can be accomplished in about sixteen seconds by 
normal children who have reached the prepubescent 
stage (age n-12). 1 A rational performance of this test 
would indicate sufficient intellectual power to warrant 
educational opportunities to be provided. 

The five Healy Form Boards are as follows: 

(1) Contains five oblongs of four different sizes, to be 
fitted into a larger quadrilateral space. 

(2) Is a larger board, containing three oblongs, two 
circles, one semicircle and four pieces with concave or 
convex ends, to be fitted into five different grooves. 

(3) Is the first of the picture form boards. It repre- 
sents a farmyard, with a mare and her colt, and sheep 
and chickens. The heads and legs of the horses, one 
sheep and one chicken are cut out. They have to be 
fitted back into their grooves. An irregular piece is cut 
out of the grassy field, and there are three geometrical 
cut-outs: two rhomboids, one of them with two blunted 
corners, and a triangle which is to be reconstructed by 

1 The Training School, June, 1912. 




Fig. 23. — Healy form board No. 3. 



SCHEDULE OF TESTS 351 

fitting two equal right-angled triangles into it. No piece 
fits into any groove but its own. (Fig. 23.) 

This form board has been found very valuable by 
many observers in discriminating between mere retarda- 
tion and real defect. Its significance is found in the 
combination it presents of pictorial and geometric ele- 
ments. The fitting of the two triangles into the larger 
one seems to present the greatest difficulty to a child 
who is unused to handling geometric forms, even though 
he may otherwise have good sense of form. The author 
has found that it is in a measure an illusion to think 
that the pictorial element is very important for the child. 
Most of his subjects were guided more by the form of 
the inset than by its significance as part of a pictorial 
whole. This is particularly striking in the fitting of the 
inset representing a blunted rhomboid. One side of it 
completes the picture of some bushes; the other is part 
of the sky. But although the piece is so cut that it 
cannot be reversed without missing its best fit, children 
would again and again try to fit it without noticing the 
pictorial clew at all. The same is true of the other 
rhomboid, which forms part of the sky with a certain 
cloud formation serving as clew. Of course this very 
observation helps in judging of the child's method of 
performing the task. 

(4) Is a schoolroom scene. Heads and arms of pupils 
and teacher form the insets, and the relative size of 
the pictorial elements in their perspective arrangement 
furnishes the clew. 

(5) Is perhaps the best Doctor Healy has produced. 
He described it in the Psychological Review, May, 19 14, 
as follows: 

The brightly colored picture, 10 x 14 inches, represents an 
outdoor scene with ten discrete, simple activities going on. 



352 



THE EXCEPTIONAL CHILD 



When properly mounted ten i-inch squares are cut out . . . 
each square bearing upon it an object necessary to complete 
the meaning of the separate activity. Besides these ten pieces 
there are forty other i-inch squares, thirty of them bearing other 
objects, and ten being blank. 




Fig. 24. 
Healy puzzle No. 5. 

Pictorial Completion Test. A test for apperceptive ability. The pieces 
which (belong in the squares are mixed with forty other pieces, all the same 
size, representing a variety of objects. From these selection is made to fill the 
spaces. The picture is highly colored. 



The task is to select the proper piece for each place. 

From what Doctor Healy further states it would 
appear that this is a good test for children representing 
what the author has called the "elementary stage" of 
development or, rather, that part of it which marks the 
gradual passing from it to the next higher stage. There 
is no absolute "mental age" limit if the author inter- 



SCHEDULE OF TESTS 353 

prets Doctor Healy's data rightly. In his summary 
Doctor Healy says: 

We evidently have in our completion picture a test for ability 
primarily adapted to the child type of mind. Every detail of 
the meaning has proved to be understandable, even by morons. 
The performance of naive individuals of ordinarily good intelli- 
gence above 10 years of age should be better than in five min- 
utes, and not more than one "illogical" and two total errors 
should be made. A worse record than this should arouse sus- 
picion of defect in mental ability. 

One great objection to the Healy Tests for use in such 
clinical work as can be carried on in schools without 
entailing much expense is their price. Realizing and 
recognizing their diagnostic value, therefore, the author 
has endeavored to suggest some simple tests which 
would at least partly cover the ground. The recon- 
struction of dissected pictures has long been considered 
helpful in determining a child's degree of judgment 
power, and it is easy for any one to arrange a series of 
such pictures in an ascending order, increasing the diffi- 
culty by increasing the number of pieces and by multi- 
plying the problems through varying the form of the 
pieces and through complicating the picture ensemble. 
Jig-saw puzzles may be included, but their value does 
not increase with the complication of the task. They 
represent more a game of patience than of intelligence. 
The cube puzzles add another feature. Usually there 
are nine cubes in a box, representing six different pic- 
tures; it is the task of the child to find the right side of 
each cube to fit into a given picture. Geographical 
puzzles are included in this series. All these puzzles 
can be bought for little money in every toy shop. 



354 THE EXCEPTIONAL CHILD 

These tests may be presented in two different ways: 
One is to place the model picture before the subject; this 
makes the task easier. The other is to have the child 
work independently with the pieces, and let him dis- 
cover for himself what the subject and composition of 
the picture is. This latter form of the test involves a 
similar mental operation to that required for Q, 3, the 
picture-arrangement test. 

Details for these tests have been given in the descrip- 
tion of the author's larger series, in his book, "The 
Study of Individual Children." 

Geometric Design and Form. — Omitting for the pres- 
ent a discussion of Test 3, Tests 4 and 5 may be intro- 
duced here, as they complete the inexpensive series sug- 
gested in a previous paragraph. Test 4, Color Cubes, is 
worked with a set of sixteen i-inch cubes in a 25-cent 
box put up by the "Embossing Company," and pur- 
chasable in most toy stores. Each of the six sides of 
the cubes is colored in a certain way, so that pretty 
color designs may be constructed. These designs may 
be made from the model, or in free invention. 

The Anchor Puzzles have been the delight of normal 
boys for many years. They are manufactured by the 
Doctor Richter's Publishing House, New York, and 
can be bought for a quarter each. (A smaller box can 
be had for ten cents.) Four different styles of these 
puzzles are being used in the author's clinic. They 
involve the construction of geometric figures (squares, 
oblongs, circles), by putting smaller geometric units 
(squares, triangles, oblongs, rhomboids, segments, sec- 
tors) together, and give occasion for much the same 
mental activity as the formal elements of the Healy 
Tests, and some of the tests introduced by Doctor 



SCHEDULE OF TESTS 355 

Knox at Ellis Island. But they offer really a far greater 
variety of fascinating tasks, inasmuch as the same pieces 
can be used for making a great number of various fig- 
ures for which model books are enclosed. For a short 
clinical examination only one of these problems is given, 





A 

Fig. 25. 

A. One of the Anchor puzzles. 

B. One of the many forms which can be constructed with the same elements. 

and the result is marked in the same manner as with 
the form boards. 

Field of Search. — Test 3 presents the task of con- 
necting 100 dots {}/2 inch apart, arranged in 10 rows of 
10 each) with a continuous line without touching the 
same dot twice or crossing over. There are only two 
rational ways of solving the problem, and only one is 
the speediest. Yet the problem can be executed in a 
number of zigzag ways which would be illustrative of 
the zigzag manner of thinking and experimenting on the 
part of the child. This task, which is a familiar psycho- 
logic laboratory test, is parallel to the well-known judg- 
ment test to find a hidden object in a field. The only 
rational method of doing this is identical with the most 
speedy method of connecting the dots. While young 
children of fair intelligence will easily hit upon the sec- 
ond rational method (passing from one row of dots to 
the next by a connecting line), the spiral solution is a 



356 



THE EXCEPTIONAL CHILD 



fair sign of mental maturing. It must be remembered 
that a child before reaching the prepubertal stage does 
not really think rationally. The budding of true reason 
occurs when a child enters upon the Intermediate Period. 
(C/. "The Career of the Child," pp. 96 jf. and 146/.) 



Fig. 26. 
Field of search — one hundred dots. 



Building and Construction. — In Test 6 the child is 
given an ordinary box, containing wooden building- 
blocks, such as one can buy in any toy store for 10 cents. 
The first task is to build some steps. It is, however, 
not necessary to make this a separate task. He may 
build the steps in connection with erecting a simple 
bridge as in the second task. Or, after constructing a 
house (Test 7), he may set it upon the inverted box 
containing the blocks, and build the steps as leading up 



SCHEDULE OF TESTS 357 

to the "porch" or "hill" represented by the box. The 
order in which the tests are given can be adjusted to 
any condition or emergency. In this, as in most of the 
tests, the task can be introduced in the form of a game. 
Have tiny dolls, or pasteboard figures, to play with, as 
living in the house, going up the steps, etc. 

It will be found that some children, and not always 
those who are otherwise unintelligent, are singularly 
incapable of understanding the simplest principles of 
construction. This may, of course, be the result of lack 
of training, of opportunity, or of observation, as well 
as that of lack of power in this field. These children 
have the general form of steps in mind, perhaps, but do 
not know how to use their material, and will merely 
pile one block on top of another, the upper ones a, little 
back of the front edge of the lower, without any prop 
to hold the upper ones in place. They will continue 
to try without hitting upon the proper construction, 
greatly distressed when they find that their steps will 
tumble down. Other children will find the proper way 
immediately. This difference is found even in children 
who have had kindergarten training, with its building 
gifts. The difference illustrates the fact that the men- 
tal activity of building from dictation and imitation is 
essentially different from building in free constructive 
effort. 

A second task, given even to those who fail in the 
first, is the building of a simple bridge over an imaginary 
brook, for which any symbol may be used: a ruler, or 
a strip of paper, or a painted representation of a brook. 
Some children will put the block which is to be the 
bridge right on the "water," and have to be reminded 
of the fact. They may think of bridge pillars rising 



358 THE EXCEPTIONAL CHILD 

from the water, not knowing of the substructure un- 
der the water. Some will start to build an elaborate 
structure up high, not thinking of the approaches or of 
the disproportion of the bridge to the brook, or to the 
little man who is to cross over it. There will be many 
individual variations in attacking the problem, for 
which few of them have any previous training. The 
observation of these variations will give the examiner 
valuable clews for appreciating a child's degree of com- 
mon sense and individual experience, and for determin- 
ing his mental type. 

Eventually the building of a house may be added to 
the task. It will be easy to distinguish between those 
who have merely an idea of form without a concept of 
construction, and those who have both, or neither. 

The construction of houses (Test 7) is somewhat differ- 
ent from the use of building-blocks of the ordinary kind. 
It involves the putting together of simple building ma- 
terial in an ascending order of difficulty. The very sim- 
plest form is that of pasteboard houses, which can be 
bought in boxes of "villages" or "toy towns" in the 
toy stores for a few cents. They are folded up, with 
the roofs and other parts removed, and can be put up 
easily. The more difficult constructions are made by 
dovetailing wooden parts, or by way of pegs, and the 
like. All these are available in any toy store. The 
familiar Meccano Game and its variations may furnish 
material for this test, which is intended to determine 
the ability of the child, understanding the principles of 
construction in each case, to "put parts together." The 
Anchor Stone Building-Blocks offer further material of 
this kind. 

The last test of this group, Mechanical Construction, 



SCHEDULE OF TESTS 359 

consists in having the child "make" something. From 
a model he may put together a wooden box for which 
the material (sides, top, and bottom) and the tools 
(hammer, tacks, etc.) are handy. Or he may construct, 
from scraps of material (pieces of tin, blocks of wood, 
cigar box, spools, package handles, cardboard, wire, 
twine, etc.) some object or model such as his fancy may 
dictate. This last test is one of those which may be 
done outside of the clinic proper, in the school itself, or 
even at home. Specimens of the child's previous inde- 
pendent work may be accepted in lieu of new work. 

S. Expression. — The expression tests as here out- 
lined refer mainly to the child's emotional quality, to 
his (Esthetic attitude and his art instinct. This instinct, 
by the way, is much more pronounced in the majority 
of children than is usually assumed. Of course, we 
must take a child's method of expression on its own 
merit, not imposing adult standards or symbols. Many 
who first assert, e. g., that they cannot draw at all, will 
surprise the examiner by the artistic quality of their 
work. 

In this field the author's own investigations have 
fully established the fact that a child passes through 
developmental periods ("culture epochs") which broadly 
correspond to the periods of civilization through which 
the race has passed. 1 The parallelism between the art 
work of children and that of savages and ancients, as dem- 
onstrated in these experiments, is certainly very strik- 
ing. It can be observed that the same biological laws 
which have determined the evolution of the human 
mind in the race are still at work in the maturing of 
l Cf. pp. 40/. 



360 THE EXCEPTIONAL CHILD 

the child soul from infancy to adult age, and shape the 
children's artistic expression. 

This point, as well as the principles underlying these 
expression tests in general, are thoroughly and minutely 
discussed in the author's book, "Some Fundamental 
Verities in Education." 

The first of these tests is largely mechanical, the 
drawing of forms through ground glass (geometrical, con- 
ventionalized, and life forms), using the well-known 
toy. It is primarily a test in motor co-ordination and 
general conception of form. 

Tests 2, the drawing of a man, a horse, and a house; 
3, drawing of pond with trees on opposite sides; and 4, 
illustration of story, are fully understood in their mean- 
ing and scoring by a study of the book referred to. 1 

1 To show the author's position at least in regard to the third task, 
the drawing of a pond with trees, the following quotation from his book, 
"Some Fundamental Verities in Education," pp. 95 Jf., will be instruc- 
tive. It will serve as an example of his procedure in the experiments 
alluded to: 

In Egyptian work all objects are so drawn as to expose their characteristic 
side to view. The ground, roads, meadows, ponds, are drawn as they would 
appear from above; a man standing on the opposite side of an oval pond looks 
as if he were placed on a blue bag. Let us look at Fig. 28, a pond with palms. 
The artist paints the pond rectangular in shape, lined in with yellow sandstone, 
just as if he were drawing a diagram or a plan, or working drawing of it. On 
the side of the pond toward the observer there stand three palm-trees; on the 
opposite side only two. Consequently three of them are drawn in front of the 
diagram, the other two behind it, as it were. 

In the experiment the pupils of all classes were requested to draw a pond 
with trees in front and on the opposite side; the rectangular form was men- 
tioned only to the primary and grammar classes. No child drew .the picture 
exactly in the Egyptian style. Five groups could be distinguished. The most 
immature method showed a radial arrangement of the trees (Fig. 29). This 
method was characteristic of 43 per cent of the kindergarten pupils; some 
pupils were found in every class up to 12 years of age who had not advanced 
beyond this primitive, or rudimentary, form of representation. The same 
method is recognized in the Egyptian picture of the brickmaker's pond, in 
Fig. 30. It is parallel to the one employed in Fig. 31, representing a shaman's 
lodge (Alaska); the figures, arranged radially along the four sides, are meant 
to designate people seated around the walls of the lodge. In the second and 
third groups the pond was drawn strictly rectangular, as in the Egyptian draw- 
ing. About 50 per cent of all drawings were of this class. Group II had the 



SCHEDULE OF TESTS 



361 



Valuable studies of children's drawings have been made 
by a number of observers like Earl Barnes, Elmer E. 
Brown, and others. Their various reports should be 




Fig. 28. 
Ancient Egyptian painting: pond with trees. 




Fig. 2g. 

Child's drawing of pond with trees: radial 

arrangement of trees. 

trees arranged in various symbolical ways, of which Fig. 32 is a fair example. 
With this may be compared Fig. 33, a symbol taken from an Ojibwa chant, 
meaning "It is growing, the tree." The symbol represents "Mide wigan (the 
medicine-lodge) with trees growing around it at the four corners." 

Group III is represented by Fig. 34, where the trees are drawn in natural 
position. Another group shows the rectangle of the pond drawn more or less 
in perspective; and the fifth, represented only by the maturest children of the 
highest classes, drew a perfect landscape. 



362 



THE EXCEPTIONAL CHILD 




c=icr> 
acn 

£^» cd a a czj cd 



r-\ 



PfWTI 





Fig. 30. — Ancient Egyptian painting: brickmakers. 



*^r I 




Fig. 31. 

Indian drawing of a shaman's lodge (Alaska), from Ann. 

Rep. of U. S. Bureau of Ethnology, 1888-89, P- 5°7- 



SCHEDULE OF TESTS 
/ 3 



363 




Fig. 32. 
Child's drawing of pond with trees, in sym- 
bolical arrangement. 
Trees 1 and 3 are meant to stand on the 
opposite side; 2 and 4 on the near side. 




Fig. 33. 
Indian drawing of Medicine Lodge. From 
Ann. Rep. of U. S. Bureau of Ethnology, 
1888-89, P- 245. 



carefully studied, as they will throw much light upon 
the significance of the drawings which will be produced 
in these tests. These tests are of great importance, 
as we may reach the soul of the child, his grasp of things 
and situations, more safely through his artistic expres- 



364 THE EXCEPTIONAL CHILD 

sion than through many another test. We may also 
liberate powerful forces for development which other- 
wise would have remained dormant and been doomed 
to neglect, suppression, and consequent disorganization 
and vitiation, so that the entire career of the child and 
his emotional life would be poisoned. 

The painting and modelling tests (5-7) need no further 
explanation. 

The author has added the singing of a song and the 
recitation of a poem or prose selection to these tests. 
There are two reasons for this: One is that the choice 
made by the child, or his hesitancy, or lack of response, 
or on the other hand his readiness or even boldness, 
allow interesting deductions to be made as to his type 
and emotional quality. Again, the trueness of his 
voice, his sense of melody and rhythm, his manner of 
reciting and singing, give valuable information as to 
the educational significance of these arts for him. 

MINIMUM REQUIREMENTS 

In their completeness even these tests, shorter though 
they are than those described in the author's book, 
"The Study of Individual Children," require so much 
time that several sessions with the subject are necessary 
to accomplish results without fatiguing him, especially 
when this subject is a child of slow response and ready 
fatigue. 

A limited number of these tests has therefore been 
selected, combining determinative elements of physio- 
logic and psychologic function with facts of individual 
ability and training, which may serve as a short labora- 
tory test sufficient for making a tentative diagnosis. 
Even this will require from one to two hours for each 




Fig. 34. — Rectangular pond with trees on opposite sides. Child's 
drawing. Trees in perspective. 




Fig. 35. — Free-hand drawing by K. B. 



SCHEDULE OF TESTS 365 

child. To expedite matters, those in the list of selected 
tests given below as are marked with an asterisk may 
be given in group work with subjects who can write well 
so that the answers may be written. 

It must be understood that, after the suggestions 
which the tentative diagnosis will carry with it for the 
child's training have been put in practice for a while, 
a second examination will clinch the most important 
facts and throw light upon the child's power to gain and 
profit from properly adjusted training. In every in- 
stance care must be taken to prepare as full a child 
history as can be obtained, and to have sufficient medi- 
cal data. 

For this shorter examination the following tests have 
been chosen (designated by the use of italics on the test 
cards) : 

A. All the visual tests (* memory tests in groups). 

B. All the auditory tests, excepting location and 
pitch, and the memory for single tone (* word-pictures 
in groups) . 

C. The tactile tests, except needle-points. 
*7. Train of ideas, complete. 

/. Imitation, complete. 

K. Of the concentration tests, only the first: Follow- 
ing directions, is included. This can be simplified by 
combining it with other tests, for instance R and 5, 
making some of the performances part of the direc- 
tions. 

L. Naming of objects, complete. 

M . Of the language tests, the first (telling story from 
pictures); * the writing of a story read by the child; 
* the completion test; * the first order of ciphers; * the 
opposites, and the * classifications. 



366 THE EXCEPTIONAL CHILD 

N. Reading, complete. 

* O. Writing, only own name and dictation, omit- 
ting the rest. Even the spelling test may be omitted 
as a separate test, taking the spelling in the language 
tests as a basis of judgment. 

P. Of the number-concept tests, only (i) counting, 
and the abacus test; (2) comparing heaps of sticks; (3) 
comparing different lengths, and (5) * problem in judg- 
ment. 

Q. Discrimination: (1) matching pictures, and (3) 
picture arrangement. By using a number of different 
sets of pictures, a group may take this test together. 
Of the illusions, only the weights, perhaps the circles. 

R. Construction: the Seguin Form Board, and 
Healy's No. 1. Reconstruction of pictures. * 100 dots. 
The building-blocks and the construction of houses. 

S. Expression: * the drawings mentioned under (2), 
(3), and (4). Also the singing and the recitation. 

SUMMARY 

The summary blank as here given is for the use of the 
examiner only. He will record his immediate findings 
as well as he can. 

He should be cautioned at the outset, however, that 
no ready-made schedule will give him the opportunity 
of proper diagnosis. He should consider the statements 
in his summary merely as additional notes, and should 
refrain from an immediate judgment. A real diagnosis 
requires thought, patience, and time. A child's condi- 
tion cannot be diagnosed as a physician may diagnose 
some specific disease. It will be well for the examiner 
to look over his data carefully, to consider his observa- 
tions and impressions, and then to write out in an 



SCHEDULE OF TESTS 367 

unscheduled form what he thinks of the case. 1 In the 
appendix a few summaries of this kind are reproduced 
to show what is in the author's mind. 

The first entry in the summary is a statement as to 
the nature of the child's response; whether it be prompt, 
slow, halting, eager, indifferent, timid, or sullen. The 
right word should be underlined. Space is left for in- 
serting any other word which would express the exam- 
iner's judgment better. 

The second item refers to fatigue. A child's slowness 
of response may be due to chronic fatigue, or to tem- 
porary fatigue at the time he is reported to the clinic. 
If his power of endurance is small and the examination 
becomes tiresome to him, distinct allowance must be 
made for fatigue symptoms, and eventually another ap- 
pointment should be made to secure the best possible 
conditions for examination. Fatigue is a danger-signal 
and may point to bodily impairment. 

Mention has been made before that the effect of school 
training and the extent of individual experience, on the 
basis of the child history and the findings through this 
examination, should be recorded here. 

The purpose of the next entry is to grade the child 
tentatively according to his period of development. As 
explained in previous chapters, the author is disinclined 
to determine "mental age" in terms of years. The 
child, however, passes through consecutive periods of 
development, each representing a more or less distinct 
stage in mental evolution, with predominant instincts, 

1 Any one interested in making exact computations of a pupil's stand- 
ing in his group, after the psychologic laboratory method, will find a 
brief and illuminating statement in Doctor Pyle's book, "The Examina- 
tion of School Children," and more comprehensive directions in Doctor 
Whipple's "Manual of Mental and Physical Measurements." 



368 THE EXCEPTIONAL CHILD 

tendencies, budding faculties, mental attitudes, etc. 
Sufficient explanation of this division has been given 
in several places so that further details are unnecessary. 

The examiner will, indeed, find this great difficulty in 
stating a child's period of development: no individual 
passes through these stages with equal rapidity in all 
manifestations of mental growth. He may be distinctly 
backward, representing a more ancient period of civili- 
zation, in some; while he is perfectly modern, or even 
in advance of his fellows and his time, in others. No 
one man comprises in his personality modern equip- 
ment or the modern intellectual level in everything. 1 
In reality, the curve of our various endowment levels 
is a very irregular one, as the diagram figure No. 36 is 
intended, somewhat crudely, to illustrate. It is this 
irregularity of mental levels which makes people differ 
from one another. Reference is here made also to 
Chapter III, in which the author has endeavored to 
show that in addition to individual differences, distinct 
civilization levels can be defined in modern society. 

We may therefore be obliged to record that a child is 
in the primary stage in graphic expression, in the ele- 
mentary stage in general intelligence, while he may 
represent an advanced stage and special talent in con- 
structive or mathematical work. Or, the order may be 
just the reverse. Many varieties are found. By study- 
ing the child in this manner it will be possible to deter- 
mine approximately his type, or the mixture of types 
he exhibits, with possible leanings in certain directions. 
The various types here enumerated may not cover the 
entire range of such tendencies and endowments, but 
are set down suggestively. Children will show mix- 
1 Cf. p. 42. 



SCHEDULE OF TESTS 



369 



16- 








































lfr 




























W 












































13- 












































12- 






































11- 






































10 ; 






































9- 








































8- 
f 

6- 








































z 
o 

O 

cc 
H 
V) 

z 

O 

o 


ID 

O 
< 

o 

z 
< 

-1 

Z 

UJ 

o 

Q- 
CO 








O 

h- 

UJ 

S 
X 

h 

cc 
< 

Ul 
> 

O 

OB 
CO 

z 
o 
o 


h 

z 

UJ 

s 
a 

D 

3 


z 
o 

h 
< 

cc 
H 

z 

O 
Z 
O 
o 


z 



h 
< 

z 
s 

cc 
O 

CO 




z 


H 
5 


z, 



1- 

< 





CO 
CO 

< 


z 


< 

Z 
Q 


6 


cc 



h 

O 
2 


z 

O 

H 
< 

O 
O 






UJ 
W 

z 

UJ 

10 

UJ 

_l 

h 
O 
< 




Z 
O 

CO 

> 




o 

UJ 

S 

X 

CC 

< 

1- 
o 
< 

cc 

H 

co 

CO 

< 


5- 


O 

Z 

CC 

< 

X 


4- 


o 
z 

Q 
< 
111 


3 


1- 

CC 
< 


2- 
1- 


z 

H 
E 


UJ 

h- 
03 
< 


_j 

UJ 

S 

CO 














Fig. 36 
























AB 


BIT1 


IAR1 


! DI 


AGRj 


\M 


df r 


.NDC 


)WM 


EOT 


3 











The line, at 9.42, indicates the average attainment, 59 per cent of the 
perfect score. Suppose the endowments of another individual were reversed 
in capacity. The average would be the same, but the type would be oppo- 
site to the one here charted. The individual type here represented would 
belong to the constructive and scientific type, possibly being inventive and pro- 
gressive, with a commercial bent, though imperfect in literacy, art, and the 
minor sense-perceptions. This type is predestined to success in achievements 
and business. While this chart is arbitrary, and anything like exact numerical 
values can perhaps never be ascertained for any of these endowments, it will 
give a fair idea of what is in the author's mind and what certainly comes near 
enough to the truth to be illustrative. 



tures of types even when they have special endowments. 
The "mediocre" child is here mentioned, preferring 
this term to the term "average," as one who does not 
show any special inclination but conforms to moderate, 
usual requirements. 

One very important point which has been but slightly 



370 THE EXCEPTIONAL CHILD 

touched before in these pages must be stated here with 
great distinctness. The old idea that there is such a 
thing as "formal training" has been given up. That 
is to say, a boy studying Latin successfully is not on 
that account better fitted to grapple with mathematics, 
or history, or nature. No one study gives anything 
like a universal mental discipline, which stands in good 
stead for the mastering of other subjects. There is at 
least no automatic interrelation of mental activities 
such as has been supposed to exist. By systematic cor- 
relation and co-ordination these activities can and must 
be organized; but that is something essentially different 
from the old notion of "formal training." Likewise, no 
excellence in any particular test in any schedule of tests is 
evidence of general mental ability. It may be accompanied 
by a most signal defectiveness along other lines. Even 
successfully passed tests of different kinds do not allow 
of generalized conclusions; it is one of the weaknesses 
of the Binet type of tests that it presupposes such a 
possibility. Each individual child represents a type by 
himself, combinations of units which in their totality 
differ from every other combination. The "mediocre" 
type presents perhaps the kind of individuals most fre- 
quently found in a community, showing minimal varia- 
tions from the mathematical average, and conforming 
to stereotyped conditions. But even children of this 
type vary considerably in the combinations of their 
mental units. Examiners must therefore be warned 
not to attempt to derive general conclusions from de- 
tached tests or observations. 

Number 7 refers to what we may call the present edu- 
cational status of the child. This entry may be made 
in the form of a brief diagnosis, referring also to the dif- 



SCHEDULE OF TESTS 371 

ferentiation of the child as suggested in the author's 
"Tentative Classification of Exceptional Children" 
(Chapter IV). In other words, it may be stated whether 
the child belongs to the group of potentially normal 
children, or to the subnormal or abnormal groups. 
Again, the subdivisions may be considered, and the 
child put down as an atypical, or pseudoatypical, or 
as a physically defective, or a submerged individual, as 
showing symptoms of arrested development, or belong- 
ing to the primitive group. The classification presents 
a number of special designations which will help in the 
final analysis and diagnosis. 

It is hardly necessary to explain the last entry in the 
summary. It is evident that a mere summary, diag- 
nosis, or attempt at one, can be of little value unless 
some practical suggestions are made as to what the child 
needs. If he is found to belong to the abnormal group, 
custodial care will have to be advised. If, however, he 
shows sufficient mental quality and stamina to deserve 
an education, the kind of training he would need so 
that he may be developed to the level of usefulness and 
independent existence in his own right must be indi- 
cated. This includes suggestions, eventually, for voca- 
tional training. 

As has been shown on page 243, there will be a num- 
ber of cases the suggestions for which cannot be ade- 
quately carried out, owing to the absence of proper 
educational and other facilities for the care of many 
types of exceptional development in children. Then, 
the clinical findings will be a strong argument in favor of 
a rigorous propaganda for establishing ample provisions. 



PART III 

THE PROBLEMS OF PREVENTION, AD- 
JUSTMENT, AND ORGANIZATION 

CHAPTER XVII 

THE PROBLEM STATED— ITS PERSPECTIVE 

Various Aspects. — In the first two parts of this book 
the different types of children which constitute varia- 
tions of the normal, as well as those which represent de- 
viations from the normal, have been fully discussed; and 
an attempt has been made to describe clinical methods 
by which we may arrive at a safe diagnosis of individual 
cases. In a measure the problem is not altogether a 
problem of the " exceptional " child, if we mean by that 
term deviations; it is a problem of the "different" child; 
that is to say, the child who differs from traditional 
standards, as well as that of the deviating child. The 
general term "exceptional" as used by the author must be 
understood as including both groups. 

Many of these variations are by no means unde- 
sirable, and even some of the deviations are not neces- 
sarily detrimental and degenerative. It is all a matter 
of individual diagnosis and handling. In fact, most of 
the "exceptional" children are "worth while," often 
more so than the conforming child. 

In this part we are to discuss the problem of how to 
meet the conditions causing eventual failure in life, 

372 



THE PROBLEM STATED 373 

whether the individual so endangered be really normal, 
or potentially normal, or exceptionally bright, or dull, 
or psychopathic, physically defective, subnormal, or 
abnormal. 

This discussion will imply considerations for adjust- 
ments in home and school for the legitimate needs of 
children who do not follow the beaten path, or who need 
removal of their handicaps to allow them to live their 
own life successfully and effectively, in its social, emo- 
tional, mental, and ethical aspects. We shall have to 
refer to those powerful influences which determine a 
child's chances even before he is born — to the hereditary 
and congenital factors. We must consider home life 
and home education; social and environmental condi- 
tions in general — the milieu, the community standards 
and community demands which affect the ideals and 
life aims of the home and of the individual child. We 
shall enter into the question of reorganizing our school 
curricula so that they may reach out with fairness and 
appreciation to different mental types. School meth- 
ods will require scrutiny in order to ascertain what 
course it is best to follow to meet the budding faculties 
at the " psychological moment." Problems of the or- 
ganization of clinical research and of medical inspection 
and co-operation will appeal to our attention. We shall 
have to discuss the factors which determine American 
civilization and democracy so that the individual may 
find his place in the world. 

In all these discussions the following four aspects 
will have to be borne in mind: 

First. — Is the condition with which we are dealing a 
manifestation of normal instincts, normal mental de- 
velopment, normal biological factors, or not? 



374 THE EXCEPTIONAL CHILD 

Second. — If it is a normal condition, what must be 
done to set the individual forces at liberty in order to 
secure for each child the opportunity for developing his 
highest possible degree of personal and social efficiency ? 
What measures must be taken to prevent derailment, 
perversion, or paralysis of the normal potentials? 

Third. — If the condition be subnormal or even ab- 
normal, what disposition must be made of the individ- 
ual? What measures of relief can be adopted? Can 
a place in human society be found for the individual 
where he can live up to the highest measure of his effi- 
ciency? Or must he be permanently segregated? 

Fourth. — What are the prospects of forestalling sub- 
normal or abnormal development? Can we prevent 
subnormal and abnormal births? Can we influence 
heredity? Under what conditions? To what extent 
can we control congenital situations and occurrences? 
How can we secure corrective influences in the early 
life of each child, as to health and disease, mental and 
moral states, emotional stimuli, and general environ- 
mental circumstances? How can we prevent an indi- 
vidual's subnormality (or even abnormality) from going 
beyond uncontrollable necessity, saving him from need- 
less degeneracy and suffering? 

Various Provisions.— In order to meet these demands 
we may find ourselves constrained to establish energetic 
and thoroughgoing activity along the following lines: 

First. — We must establish new standards in the home, 
school, and social life, so as to recognize present-day 
conditions, scientific principles, and the fact of varia- 
tion of type. 

Second. — We must study and improve the legal status 
of the child, as to his educational opportunities and his 
occupational differentiation. 



THE PROBLEM STATED 375 

Third. — We must establish principles of eugenics on a 
rational basis, free from sensational and hysterical ele- 
ments, which will tend toward a cleansing of the human 
race of unsound and degenerative influences. 

Fourth. — The problem of a sane and sweet home life 
and of a wholesome home education must be studied and 
understood in all its bearings upon the natural develop- 
ment of the individual child. 

Fifth. — The ethical and religious element in education 
must be fully recognized and given its place as a most 
powerful agency in bringing about normal life conditions. 

Sixth. — The economic, political, social, and ethical 
atmosphere of the environment must be appreciated as a 
determining factor in shaping an individual child's 
ideals and destiny. 

Seventh. — There must be opportunities for a careful 
scientific valuation of each individual child. Clinical tests 
must be established for all children, those at home and 
those attending school, to be applied at regular inter- 
vals for the purpose of following them through the dif- 
ferent, successive periods of development to catch the 
budding time of their faculties, to adjust training to their 
changing needs, and to recognize their individual genius 
and type. 

Eighth. — This clinical work must be organically co- 
ordinated with a thorough system of medical examina- 
tions through the family physician, the medical inspector 
of schools, and other similar agencies, so that the bodily 
health of the child and his physiological peculiarities 
may be thoroughly safeguarded. This health aspect of 
the problem should be organized in connection with 
health boards, sociological investigations, friendly visit- 
ing, parent- teachers associations, provisions for psycho- 
logical and psychopathic research and examination. 



376 THE EXCEPTIONAL CHILD 

These clinical researches, educational, psychological, 
medical, and sociological, will establish, with some de- 
gree of accuracy, the educational problem of the individual 
child. 

Ninth. — Parents, teachers, and educational workers gen- 
erally must be so trained that they appreciate these indi- 
vidual problems and deal with them intelligently. They 
must learn to recognize ordinary and typical differences 
as well as danger-signals in cases of impending disease 
or derailment — physical, mental, or moral. 

Tenth. — We must put our courses of instruction, our 
methods of presentation and training, our grading and 
grouping, our promotions and graduations upon a 
strictly scientific basis, meeting the individual variation 
at every point so as to achieve the highest efficiency of 
each. 

The present school organization must be so recon- 
structed that typical differences be met by special pro- 
visions. There should be differentiated courses for the 
manual and constructive, the artistic, the non-literary as 
well as the literary type, etc. There should be what has 
been called vocational guidance at such junctures in the 
life of each individual when such guidance is needed — a 
guidance which will be based upon a scientific diagno- 
sis of the individual's type and level of efficiency. This 
must not be understood to mean that the individual 
training should be one-sidedly "practical," or rather 
what may be called readily "coinable" in the currency 
of business success; but it means that the special bent 
be used as a point of vantage, as the angle of vision 
from which a fundamental, broad education may be 
approached, making due allowance for excellences and 
weaknesses, without robbing the child of the needed 



THE PROBLEM STATED 377 

opportunity to round out his culture. Yet we must 
bear in mind that the fetich of ''formal culture" has 
lost its halo, and that most of the "all- 'round" culture 
needs revision on psychologic principles. 

In the last chapter of the author's book, "The Career 
of the Child," the suggestion of using the special bent 
as a point of vantage is more fully elaborated in the 
matter of high school differentiation. 

Eleventh. — The life of the school child should not be 
confined to four walls. The less of school palaces we 
have, accommodating hundreds and even thousands, and 
the more of smaller, convenient buildings we substitute 
for them, the better. There must be ample space for 
the children — outdoor space as well as floor space. 
There should be much open-air work, open-air gymnasia, 
etc., not only for children afflicted with pulmonary dis- 
ease, anaemia, or similar ailments, but for all children. 
There should be laboratories, art studios, workshops, mov- 
ing pictures, and a host of other things which will enrich 
and enliven the school-days of our children. 

Twelfth. — The day schools should be supplemented by 
special institutional schools. A small number of these 
will serve to house the permanently disabled, those who 
ought to be under custodial care, like the feeble-minded, 
demented, and epileptics. In most instances these in- 
stitutions should be in the nature of colonies. A much 
larger number of institutions will be required for other 
special purposes. There should be sanatorium schools 
for the atypical, the neurasthenic, the psychopathic 
child. Home schools should be provided for those who 
need a revision of their environmental and educational 
influences, as in the case of children with disintegrated 
moral instincts, or of those who are neglected and des- 



378 THE EXCEPTIONAL CHILD 

titute, or whose mental life has become cramped and 
stunted under the restrictions of congested life condi- 
tions. 1 There should be forest schools, farm schools, 
mountain camps, camps by the seaside, etc., to meet vari- 
ous conditions. And all these should be under the direc- 
tion of the school authorities, not in the sense of punitive 
institutions like the regulation reform school, nor in the 
nature of a charity — they should not be under the direc- 
tion of state or municipal boards of charity and cor- 
rection or left to the chance efforts of private charity. 
Correctional and punitive measures are indicated only 
in the gravest cases of misdemeanor, and even then 
the educational aspect should be primary, the educa- 
tional authorities should be co-operative, and clinical 
methods of diagnosis should be employed. With every 

1 Nina L. Crawford, supervising principal of the Newton School, makes 
a plea for the parental school in the issue of The Teacher (Philadelphia) , 
of May, 1915. She says: "We read of what Thomas Mott Osborne is 
doing at Sing Sing, sociologically, and of Henry Ford's great and glorious 
work in reclaiming convicts by employment, and we are reminded more 
than ever of the great need of parental schools, in order to reclaim the 
so-called 'bad boy.' In our great public schools, to be sure, we find 
special disciplinary classes for the poor incorrigible boys — those who 
have proved themselves unfit to stay with the other or normal pupils. 
Many of these sad derelicts are very happy and good while in the special 
school. ... If, therefore, they can be so easily and happily guided 
into proper habits of work and play, why not continue this glorious 
work after school hours? Instead of this, these boys are dismissed after 
five hours in school, and what becomes of them during the remainder of 
the twenty-four hours ? Oh, the sadness of it — the wicked language and 
habits learned on the streets, in the dirty, poverty-stricken homes of 
many. Some of our boys have often been out all night; then, afraid to 
go home, have come to the school as a refuge, dirty and without break- 
fast. Many of the boys prove that they prefer the school to the home. 
Their willingness to assist the teachers, their teachableness, and frequent 
docility make us often long to keep these boys for all of the twenty-four 
hours so that the good habits may become permanent. The good done 
in school is frequently undone at home. . . ." 



THE PROBLEM STATED 379 

juvenile court, with every charity organization, or 
charity board, there should be connected clinical agen- 
cies for the determination of the mental and physical 
status of the offending, or neglected and dependent 
child. 

All this means an entirely new attitude toward the 
practical problems of education, charity, and correction. 



CHAPTER XVIII 

LEGAL PROVISIONS FOR EXCEPTIONAL CHILDREN 

Before entering upon a discussion of the various fac- 
tors for relief and adjustment suggested in the previous 
chapter, it may be well to review briefly existing legisla- 
tion and the general policy of legislative measures point- 
ing toward such relief and adjustment as far as school 
legislation is concerned. 

Compulsory-Education Laws. — One of the fundamen- 
tal things in planning relief of the situation is the recog- 
nition of the principle that education is a public function, 
or at least a public responsibility. This implies com- 
pulsory education — the placing of each child under such 
educational influences as will secure for him (or her) the 
fullest possible opportunity for obtaining an education 
commensurate to his or her needs and capabilities. 

There are still six Southern States in which, owing to 
a misconception of the principle of personal liberty, 
school education is merely optional with the parents or 
guardians of children of school age. The other Southern 
States have recently adopted laws similar in purport to 
those which have obtained in the North for many years 
past. There are, then, compulsory-education laws in 
forty- three States. 

There are a few interesting facts to be observed in 
connection with these conditions. 

i. In the South it is the prevailing custom to segre- 
gate the colored school population in separate schools, 
in some cases even going so far as to make it a misde- 

380 



LEGAL PROVISIONS 381 

meanor for children of one color to attend a school 
established for children of another color. This segre- 
gation is not decreed for pedagogical reasons, or because 
the educational problem of the colored child is consid- 
ered different from that of the white (as it certainly is) ; 
but merely from what has been called "race-prejudice." 
In some compulsory-education States, like California, 
provision is made, for similar reasons, to have separate 
schools for children of Indian or Mongolian descent. 

These arrangements are a long way from the appre- 
ciation of the difference in the educational problems 
which a closer scrutiny of child and race psychology 
may reveal. 1 

2. The non-compulsory States do not exclude any 
class of children from the public schools, which are 
optionally open to all children of certain ages. The 
natural conclusion is therefore that these States cannot 
discriminate against difficult, defective, or feeble-minded 
children. Yet the provisions for these classes of chil- 
dren do not seem to be adequate, nor is their problem 
stated distinctly. In almost all States, however, 2 where 
a compulsory-education law has existed for some time, 
it is definitely stated that children whose physical or 
mental condition is such as to make their attendance 
at school inadvisable, may be excused. In some States 
medical examination is provided for such cases. This 
clause refers not only to children suffering from tempo- 
rary or infectious disease; but likewise to the deaf and 

1 Cf. Chapters III, IV, IX, and XI. 

2 Except Iowa, where a child may be excused for "sufficient reasons" 
by a court of record; Michigan and New Mexico, where only physical 
unfitness is mentioned; Porto Rico, where physical or mental incapacity 
is not mentioned at all; and West Virginia, where some "reasonable 
cause" may excuse a child from attendance. 



382 THE EXCEPTIONAL CHILD 

the dumb, the blind, the epileptic, the crippled, the 
otherwise disabled, and also to children of "defective" 
or difficult mental development, including the feeble- 
minded. In a number of States (and communities) there 
are also special provisions empowering school boards to 
exclude from school those children whose continued mis- 
conduct makes their further stay in the schoolroom un- 
desirable. Compulsory education for the deaf, dumb, 
and blind children is provided in California, Indiana, 
Kansas, Maryland, Massachusetts, Michigan, Montana, 
Nebraska, New Jersey, New Mexico, North Dakota, 
Oregon, Rhode Island, South Dakota, Utah, Vermont, 
Washington, and Wisconsin. This, however, does not 
imply in every case that the State provides the instruc- 
tion or the institution. 

It should be added that even in some of those States 
and communities where public school systems have been 
developed to include day school classes (so-called special 
and ungraded classes) for certain groups of exceptional 
children, especially for what is loosely called the "sub- 
normal," parents cannot be legally compelled to submit 
to the removal of their children from the regular class 
into a special class. 

Failure to Provide for Excluded Children. — The ques- 
tion arises: What provisions are in existence to meet 
the cases of children to whom the public day school is 
closed ? 

This question is not easily answered, as there is no 
complete compilation of all the school laws and provi- 
sions existing in the different States and municipalities. 
The main difficulty confronting the investigator is the 
fact that provisions for children are divided among 
various official departments, the educational department 



LEGAL PROVISIONS 383 

being the least concerned, legally speaking, in the care 
of the exceptional child who is largely under the guard- 
ianship, very unjustly so, of the departments of charity 
and correction, health boards, and other non-educational 
agencies. Besides, there are marked differences be- 
tween State provisions and provisions made by chartered 
municipalities. The codifying of all these various con- 
ditions is therefore very laborious. Even the publica- 
tions of the United States Bureau of Education do not 
contain complete information, or readily accessible ma- 
terial, and inquiries have only shown how much need 
there is for a comprehensive tabulation of all existing 
laws, provisions, institutions, etc. The author has culled 
some interesting data from the material at hand, al- 
though it is not impossible that some of his details may 
be incomplete or even inaccurate. 

One conspicuous defect may be mentioned first. 
There are States where children are exempt from atten- 
dance whose parents are too poor to send them to school 
decently clothed. Nowhere is it mentioned what is to 
become of this miserable class of children, unless it were 
that they will sooner or later be picked up by truant or 
police officers as "vagrant, neglected, dependent," per- 
haps even "criminal" children. There seems to exist 
no legal provision for caring educationally for these 
unfortunates until they are picked up by charity, or 
until they come under the control of penal law, that is 
to say, after they have drifted onto the refuse heap of 
society. 

While the poverty plea for the exemption from school 
attendance is distinctly incorporated in the laws of such 
States as Colorado, Arkansas, Connecticut, Missouri, 
Tennessee, North Carolina, Nevada, North Dakota, 



384 THE EXCEPTIONAL CHILD 

and Utah, only eight States have laws to allow clothing 
and other necessities to be given to indigent children 
so that they may attend school. Clothing is provided 
in many State institutions for blind, deaf, and feeble- 
minded children. But for normal children from poor 
homes it is not provided in forty-one States until they 
are picked up as transgressors from the street. 

Here, as in a number of other things pertaining to 
children, too much is yet left to the initiative and char- 
ity of private individuals and organizations. 

When it comes to the delinquent child — the child whose 
chances for right living have already been prejudiced 
by the neglect or ignorance of those responsible for his 
bringing up — provisions become plentiful. Penal insti- 
tutions for the young, whether they are called reforma- 
tories, industrial schools, State homes, or what-not, 
have existed in all States for many years, and the 
method of committing children or youths to them is 
everywhere very much the same. It is largely a func- 
tion of courts and police, although in some instances 
the school authorities have the first word in the matter. 
This latter arrangement is found where there are truant 
officers appointed by the school boards, and where 
there are truant schools under the management of the 
school authorities. These truant schools are often 
styled "parental schools." 

With the exception of some of these parental schools, 
there is too much of prison regime and too little of truly 
educative discrimination and training in the reforma- 
tories and industrial schools to which the youthful 
criminal, and what has been called the "incorrigible 
child" are committed. In many cases these children 
are handed over by the courts to private, often denomi- 



LEGAL PROVISIONS 385 

national institutions, not all of which are conducted on 
psychological principles. 

With some notable exceptions, even the industrial 
training which the offenders receive is hardly educative 
in character. Correction, reform, is nominally one of 
the aims of commitment; but the organization of these 
institutions is too plainly prison-like to make correction 
an educational element. This judgment does not fit all, 
but most of these places, and it is notable that few have 
educators as heads or superintendents, and that they 
rarely form an articulated part of the educational sys- 
tem of the State or community which maintains them. 

Truant schools are the nearest approach to a rational 
treatment of the habitually vagrant and idle child, as 
they recognize the educational character of the problem 
most readily, even though the method of commitment 
is often punitive. Even here it is only a matter of 
recent progress that the state of truancy is becoming 
appreciated as a developmental symptom. 

Children's Courts. — The establishment of children's 
or juvenile courts, with special judges to preside over 
them, and often a staff of medical officers connected 
with them, also the system of probation, have done much 
toward developing a better understanding of the youth- 
ful offenders and of the causes of their delinquency. 
The main portion of the work, however, has been done 
by private charitable societies, with their visiting nurses, 
friendly visitors, and field-workers of different kinds. 
Even the probation system is yet too loosely allied with 
the school system, and the methods of dealing with 
child delinquents are still so unscientific that much 
further research and organization are necessary to make 
a solution of the problem possible. 



386 THE EXCEPTIONAL CHILD 

Legal Provisions for Subnormal and Abnormal Chil- 
dren. — "Incorrigible," delinquent, and truant children 
are not yet recognized as suffering from impaired poten- 
tials, being potentially normal {cf. Chapters VI, VIII, 
and X). But even for those who are commonly under- 
stood to be " defective," that is to say, mentally defec- 
tive, or physically defective, no clear system is generally 
followed in States and communities. To quote from a 
letter received from the United States Bureau of Edu- 
cation: 

A number of States provide for the compulsory education of 
the deaf and the blind, but such provisions are not usually in- 
corporated in the general compulsory laws. 

It is not customary for the States to require local school cor- 
porations to provide special schools for their deaf and blind, 
since the care of those unfortunates is generally considered a 
State duty. Certain States, however, specifically authorize the 
districts to maintain such schools, and some do so. 

State provision for the feeble-minded is not universal, but 
provision is made for such children, more or less effectively, in 
perhaps the majority of the States. I am not able to make 
general statements with confidence concerning the laws for the 
care of the mentally deficient, however, for such laws are often 
classified with those relating to charities or the insane, and I 
am not by any means sure that our information upon that sub- 
ject is complete. It is not customary to establish State insti- 
tutions for merely dull or backward children, nor are they ex- 
cepted from the compulsory attendance laws. So far as I know 
there is nothing to prevent any school board from segregating 
such children in special classes. 1 

Concerning children of sound mind but with crippled or de- 
formed bodies, the laws are silent in most of the States. In 
Illinois boards of school directors may establish schools or classes 
for them, and in Wisconsin they may be sent to the State public 
school for neglected or dependent children (! ) 

1 Cf. p. 382. 




Fig. 37. — Main court-room. Children's Court, East 22c! Street, 
New York. 




Fig. 38. — Small court-room, Children's Court, New York. Judge 
Hoyt sitting in "The Heart of the Children's Court." 



LEGAL PROVISIONS 387 

Such schools are without legal obligation, and the most that 
any State does is to authorize them. It may be assumed that the 
constitution and laws of every State require that provision be 
made for the education of all children of stated ages, and nowhere 
do we find that children with crooked legs are excepted. These 
children are not compelled to attend school, but if they wish to 
do so and if the proper authorities see fit to provide for them, 
there is no legal reason to the contrary, and permissive laws are 
superfluous. 

This is true enough. But if we remember the de- 
mands made at the close of the previous chapter as to 
provisions for the relief and adjustment of the problem 
of the exceptional child, we must recognize that legis- 
lation for a suitable education of all children of school 
age is still imperfect and obscure, and that for a great 
percentage of handicapped children — those that are in 
need of specialized educational facilities — there are no 
laws compelling and facilitating their attendance at 
school. They are left to the tender mercies of ignorant 
and often criminal parents and guardians. For the 
very ones that would need education the most to fortify 
them against the dangers of physical or mental infirmity 
practically nothing is done. It still requires much per- 
suasion to convince legislative bodies that appropriations 
for handicapped children are necessary investments; 
that it is false economy to save on the educational side 
and then to spend many times as much for meeting the 
situation caused by the presence of derailed, defective, 
ignorant, and vicious elements in society. 

Not because the author believes in the correctness of 
the dire prophecies uttered by the advocates of "natural 
selection" in the affairs of men, but merely for the sake 
of completeness of the argument, reference may be made 
here to the warnings of a certain school of physicians 



388 THE EXCEPTIONAL CHILD 

and sociologists who claim that progress in curative and 
preventive medicine is decreasing the race's hard-won 
immunity to certain bacterial diseases and bringing 
about a weakened race. They point with emphasis to 
the ancient practice of killing the weak infants, allowing 
only those to live who gave promise of health and 
strength. The same argument is used against the 
making of provisions to give backward, "different," and 
handicapped children their chance. They claim that 
those who are unable to maintain their independent ex- 
istence unimpaired in the struggle of individuals should 
be allowed to perish, so that the "fittest" may survive. 
This is a convenient philosophy for the policy of "laisser 
alter" for those who believe in might above right, in the 
supremacy of the strong over the weak. Not only, 
however, is this philosophy apt to be wrecked on the 
shoals of criminality and pauperism — having to pay for 
its own folly in terms of police, courts of justice, prisons, 
almshouses, and general social unrest and insecurity; it 
has been demonstrated over and over again that these 
apparently weaker by-products of civilization have in 
them a dynamic force of considerable magnitude which 
can be turned toward constructive social activity. The 
first chapter of this book treats of these conditions quite 
fully. In a previous paper by the author 1 mention was 
made of one group which, measured by the ancient 
standard of physical strength, would have been con- 
demned to perish — the group of neurotics, which never- 
theless has furnished to mankind leaders of thought and 
action, of ideals and of ethical uplift. 

Extension of the Compulsory-Education Laws. — The 
National Education Association, in its annual meeting 
1 " Sane Eugenics," published in Educational Foundations. 



LEGAL PROVISIONS 389 

of July 13, 191 1, at San Francisco, Cal., embodied in 
its') declaration of principles the following resolutions 
bearing upon the problem of exceptional children: 

Realizing the fact that a large percentage of children whose 
physical and mental peculiarities require special methods of 
education are still to a great extent outside the scope of the com- 
pulsory-education laws, and that the presence of the exceptional 
child in our modern civilization constitutes a problem of the 
greatest import, it is the sense of this Association that the com- 
pulsory education laws of States and communities should be 
so amended, developed and extended that they shall be made 
to apply to all children of school age, without exception, and 
provide for their training; further, that the laws should recog- 
nize the difference between the chronological age of a child and 
his maturity, and that the school-age limit of each individual 
child be determined by requiring the child to meet physical and 
mental tests, even though the child be in years above the age 
standard; in other words, a child's actual age should be deter- 
mined by physio-psychological data corresponding to the nor- 
mal standard for the age limit required by law. All children or 
persons failing to meet such maturity test at the extreme school- 
age limit should remain under public supervision and control, 
either until they reach such maturity, or permanently. 

The same principle should be the guide in determining 
whether a child is fit to be employed in any occupation. Not 
when a child is fourteen or sixteen years of age, but when he 
possesses the maturity of body and mind proper to the normal 
child of that age, should he be released from the guardianship 
of the State or the community. Child-labor laws should be so 
modified as to meet this requirement. 

These paragraphs were submitted to the committee 
on resolutions by the author, himself a member of the 
committee ; they embody the same demands which were 
contained in the resolutions proposed and adopted a 
year before at Boston by the department of special edu- 
cation of the N. E. A. The wording is not quite in 



390 THE EXCEPTIONAL CHILD 

accord with the ideas presented in this volume, but clear 
enough to be revised in the sense of the author's own 
statements. 

The San Francisco resolutions scrutinize the age limi- 
tations as stipulated by the compulsory-education laws. 
They demand that a distinction be made between the 
age of a child, or person, in years, and what we may call 
maturity. Normal standards, as we have seen, 1 are 
difficult to determine with absoluteness and accuracy; 
but normal maturity can be approximately ascertained 
by appropriate tests, such as have been described in the 
second part of this book. It is now demanded that 
compulsory laws be so amended that they compel at- 
tendance not for children between the ages of 6 and 16, 
for example, but for children who are mentally the 
equals of normal children representing the correspond- 
ing periods in a child's life. There are children who, 
at the age of 6 are still infants mentally, and perhaps 
physically; and others who, at 16, are still in an under- 
developed condition. Again there are children, as we 
have seen, who are rapid growers, mentally and physi- 
cally, and should not be compelled, although below the 
chronological age, to remain in school when they have 
reached that maturity of mind and body which the law 
is intended to safeguard before the child is dismissed 
from the educational obligations which it owes the com- 
munity. 

The demand that all children or persons failing to 
meet maturity tests (such as will determine the indi- 
vidual's ability to take care of himself as far as a child 
of that age can do so) shall be under public supervision 
and control, either permanently, or until they reach 

1 Cf. Chapter V. 



LEGAL PROVISIONS 391 

maturity, is far-reaching in its effect. Even now a child 
is not removed from the guardianship of his parents 
until he reaches what is called majority, as he is not 
considered sufficiently self-directing, as an independent 
member of society, before that time. These provisions 
are made on the supposition that the child has a fairly 
normal growth. 

But the demand referred to in the previous paragraph 
gives to organized society the function of control of all 
persons who are incapable of taking care of themselves, 
irrespective of parental guardianship; or incapable of 
competing normally with others for an independent 
place in life, on the basis of true efficiency; or who may 
become a menace to society at some time in their career. 
This function implies prevention instead of an uncer- 
tain cure, or instead of eventual pauperism or criminal- 
ity. It implies the forestalling of evil tendencies in- 
stead of first letting them run wild and then running 
after the evil-doer. It means beginning at the right end 
of the line instead of at the wrong; saving money, and 
social unrest and turmoil. In this manner alone would 
society take a positive measure toward eradicating evil, 
by gradually making it impossible for immature, ab- 
normal, and dangerous individuals to be at large and to 
propagate their kind. 

The San Francisco resolution contains the significant 
provision that such public guardianship will be with- 
drawn as soon as an individual has reached maturity. 
This naturally implies that ample provisions must be 
supplied to give those children who are merely back- 
ward, slow, or non-conforming, full opportunity for de- 
veloping their natural gifts. To them this guardian- 
ship really means an educational franchise — a liberation 



392 THE EXCEPTIONAL CHILD 

from the bondage of ignorance and inefficiency, an op- 
portunity for their native intelligence to assert itself, a 
rescue from undeserved failure. 

This guardianship by the body social may necessitate 
eventually a rescue of the child from economic pres- 
sure. Just as we are now having mothers' pensions or 
stipends, we may have to have children's stipends to 
secure for them the benefits of an education sufficiently 
prolonged to put them on their feet. 

The demand has its effect, of course, also at the other 
end. For the exceptionally bright child, provided his 
body is adequate to the demands of his mind, the possi- 
bility of an earlier independence should be secured, and 
we may even modify the laws of majority for them so 
that they may be free from parental guardianship at a 
time which is commensurate to their rate of growth and 
development. 



CHAPTER XIX 
EUGENIC CONSIDERATIONS, MARRIAGE, AND HEREDITY 

Scarecrow Eugenics. — Eugenics has become a house- 
hold word in many American families, and a great deal 
has been said and written about this new science. It is 
held up to our thoughtless youth of both sexes as a sort 
of scarecrow, to frighten them into good behavior. Of 
course it really means the study of the laws which 
govern the production of healthy offspring. As such it 
is an interesting and helpful study for all thinking men 
and women, and has its special message to prospective 
parents. Unfortunately, the laws of heredity and of 
transmission of characters which are at the bottom of 
this new science have so far been studied largely in their 
application to a relatively small number of plants and 
animals from the point of view of the breeder. A 
breeder is interested in controlling certain desirable 
points. The study of the transmission of such special 
traits, and of producing them by special methods is rela- 
tively simple. It is, however, not so simple to apply 
these standards to human individuals whose physical 
well-being, intellectual qualities, mental and emotional 
sanity, and moral character represent a complexity of 
organization of which psychologists and students of 
human nature in general are only beginning to be aware. 

"The world is not yet a stock-farm," said a news- 

393 



394 THE EXCEPTIONAL CHILD 

paper writer in commenting on a previous article of 
the author on this topic. And he continues: 

That there is a foundation of good sense in eugenics goes 
without saying. But the most sensible theory may be pressed 
to ridiculous extremes. Marriages are not merely breeding ex- 
periments. Men and women will never consent to be mated 
as if the world were a demonstration stock-farm. The true 
marriage is a union of affection — a happy comradeship of two 
congenial chums. Either party to the contract may lack physi- 
cal perfection and both be entirely content. Milton was blind, 
Pope a hunchback, William of Orange an asthmatic and dys- 
peptic, Heine a lifelong invalid, Stevenson a consumptive. The 
world could spare a million physically perfect athletes much 
better than it could spare the immortal works dedicated by 
those sick and crippled sons of genius to the happiness and gain 
of the ages. 

Restriction of Marriages. — An unfortunate interpre- 
tation of the new science of eugenics has led legislatures 
to dabble in the field of natural selection. Laws have 
been enacted to make marriage dependent upon clean 
bills of health for both contracting parties. Other en- 
actments demand the sterilization of the so-called unfit. 

There are, however, two sides even to the most rea- 
sonable-looking proposition. 

Restriction of marriage, for instance, is a two-edged 
sword. It may, of course, prevent to some extent the 
mating of partners unfit for one another and who may 
produce unfit offspring. But it will never regulate pas- 
sion. Passion defies law. And passion, which is, after 
all, God-given, is sometimes sounder than law. Of 
course, what is meant here is not the mere low animal 
passion of sex-gratification, but that highest of all human 
passions, the theme of the songs of all poets, of the 
dreams of all philosophers — love. How elemental this 



EUGENIC CONSIDERATIONS 395 

passion is, how it is the mainspring of all human actions 
and of all human progress, even the gentle German poet, 
Schiller, has recognized when he sang: 

"So lange, bis den Bau der Welt 
Philosophic zusammenhalt, 
Erhalt sie ihr Getriebe 
Durch Hunger und durch Liebe." 

Love defies mere cold reasoning, and it is a question 
whether the instinct of love does not more often lead 
along the right path than the little bit of fragmentary 
reason which men may boast of. Reason is a spark of 
the divine fire, true enough. But it is a very little spark 
as compared with God's wisdom, which has implanted 
in the human heart these three great things: faith, hope, 
and love— which cannot be defined in human terms. 
They are reverberations of the eternal in the human 
soul. And the greatest of these is love. 

The more difficult it is made to contract marriage the 
stronger will be the temptation to enter into illegitimate 
matings. Defiance to law and to accepted institutions 
on the part of parents adds an element of danger to 
children resulting from such union which is absent from 
the "regular" family, no matter how well or ill-mated 
the parents may be otherwise. The illegitimate child 
is born with a stigma, without taking into account other 
possible handicaps, in physical development, intellect, 
or disposition. The innocent victim of "illegitimate" 
relations often grows up in an unwholesome and dis- 
credited social environment which prejudices his best 
chances from the start. On the other hand, it is often 
found that the "child of love," the "illegitimate" child 
born of normal parents who defied the established order 



396 THE EXCEPTIONAL CHILD 

of things, bears the stamp of strength of character and 
even of genius. 1 

We may, of course, have to be temporarily satisfied 
with some makeshift laws which offer a modicum of 
protection to society from the effects of ill-advised mat- 
ings in which animal passions or recklessness were the 
determining factors. As long as we cannot rely upon 
the ability of certain classes of our population to realize 
the grave responsibility implied in the marriage vow, 
we must have immediate means of control, as far as it 
goes, in our power. To many, alas, the sacred mys- 
tery of human life and procreation is a sentimentless, 
commonplace affair — nay, even a joke, more or less 
unclean. For lack of anything better we may for the 
present need to invoke in some manner the majesty of 
the law for such, to inspire some semblance of awe. 

It is, however, likely that other and more effective 
measures can be devised to accomplish the same end. 
One .of the gravest dangers, for instance, comes from 
the transmission of venereal diseases. If venereal diseases 
were made reportable, as is the case with other virulent 
contagions, much of the danger of undesirable mating 
would be avoided. There is at present no State in the 
Union where syphilis, gonorrhea, and other venereal con- 
ditions, primary or secondary, are included in the com- 
pulsory list of reportable diseases. 

Sexual Education. — Spreading proper knowledge on 
the wonders of procreation will also reduce the dangers 
of ill mating. From this point of view the recent agi- 
tation for training in sex hygiene is intelligible. But 
even this propaganda has suffered from the infusion of 
hysterical sensationalism, from dwelling on the wicked 
1 Cf. p. 228. 



EUGENIC CONSIDERATIONS 397 

and horrible features of perverted sex instinct. Problem 
plays; moving-picture shows on the social evil and the 
white-slave traffic; the formation of school classes, with- 
out proper discrimination, for teaching the biology of 
sex; and an emotional (erotic) agitation in general are 
apt to do more harm than good. They appeal to curi- 
osity and may dull the natural sense of modesty and 
privacy. 

Chapter XI of this book contains pertinent remarks 
on sexual education. 

Rarely has a saner statement been made than the 
one which Doctor C. B. Bardeen, dean of the medical 
school of the University of Wisconsin, made to the 
editor of the School Bulletin (Syracuse, N. Y.) , and from 
which the following sentences are quoted: 

I remember when in Baltimore being much impressed with 
the truth of a remark made by Judge Morris, who had had to 
preside at a trial in which much testimony concerning the sex- 
organs and their physiology had to be introduced. He said the 
trial made him quite uncomfortable; that healthy people did 
not think much about the sex-organs, and he in all his life had 
not given them as much thought as during the trial, and hoped 
he would not have to again. Curiosity, passion, and idleness 
are the only features, outside of medicine, that call attention 
to the sex-glands; and of these the first two are essential, the 
third being merely a contributing factor. Public talks to chil- 
dren will be pretty certain to arouse curiosity. They certainly 
will not subdue passion. In so far as curiosity concerning sex 
matters is spontaneous and natural, it may be best turned in 
legitimate directions by quiet private talks with pure-minded 
friends. . . . On the other hand, every effort should be made 
to suppress all of the many features that arouse an unnatural 
and unhealthy interest in sex. So far as passion is concerned, 
it can be controlled only by the habit of self-control and the 
right kind of personal ambition, and these can best be cultivated 
in the young without reference to the physiology of sex. 



398 THE EXCEPTIONAL CHILD 

To throw the burden of sex instruction and sex ethics 
upon the schools is but another symptom of the modern 
tendency to make the school the vehicle of most of 
those influences which heretofore have been the privi- 
lege and sacred function of the home. It signalizes the 
progressive dissolution of home life. 

Sterilization of the Unfit. — Admitting that we need 
the unfettered normal instincts of love and selection, 
guided by wisdom and self-direction, in establishing 
conjugal relations, and proper constructive and preven- 
tive methods in education regarding these relations to 
conserve the physical and spiritual welfare of the com- 
ing generations, we have to consider the problem of the 
"unfit" who are of our day. A seemingly simple and 
radical measure recently advocated, and legally enacted 
in some places, is the sterilization of the "unfit." In 
weighing the conflicting arguments for this measure 
we are confronted with considerations of the deepest 
import. Its advocates may seem justified in their 
course by pointing to obvious specimens of gross physi- 
cal and mental defect. Of course there are such de- 
generates and defectives of an unmistakable type. It 
is perfectly natural that we should not wish their kind 
propagated. But the danger of perpetuating these 
types can be materially minimized by establishing well- 
regulated custodial care for these unfortunates before 
they reach the age of puberty. Certain classes of defec- 
tives are naturally sterile, and the stock would die out 
in a few generations unless fresh, healthy blood were 
infused. 1 And we must not forget that the number of 
these patently defective persons is small. To show how 

l Cf. "The Career of the Child," chap. XIX, "Criminality in Chil- 
dren," p. 314. 



EUGENIC CONSIDERATIONS 399 

erroneous it would be to treat feeble-minded heredity 
as a simple problem, the following report which ap- 
peared in the public press a few years ago may be 
quoted: 

Nothing in the brief history of that newest of the sciences, 
eugenics, has been so baffling as the existence of the intelligent 
children of feeble-minded parents. There are on record in- 
stances of boys and girls springing from a degenerate ancestry 
going back some generations. Yet those boys and girls are 
sometimes very creditable specimens of humanity. The facts 
in their cases are not less puzzling than the splendid children 
resulting from the union of alcoholic parents who were studied 
at length by Doctor Karl Pearson a few years ago. 

Instances of this kind prompt Doctor Charles B. Davenport, 
of the Carnegie Institution, to propound a theory on the trans- 
mission of the feeble-mindedness of a kind, notes London Nature, 
very different from that suggested by himself and Doctor Weeks 
two years ago. According to Doctor Davenport's earlier view, 
feeble-mindedness and epilepsy are both due to the absence of a 
"gametic" or hereditary factor, the presence of which is neces- 
sary for normal development. They are thus transmitted as a 
simple "recessive" or latent character which might appear in 
either or both of these forms. 

Results quite incompatible with this are yielded by material 
just collected by Professor Davenport for the Eugenics Record 
Office, on Long Island, in New York. Another and more com- 
plex theory is suggested. Thus, when two feeble-minded par- 
ents whose defect is of the same type are mated, all their chil- 
dren will reproduce it. Where, on the other hand, the type of 
mental defect of one parent is different from that of another's, 
none of their children are necessarily feeble-minded at all. In 
the language of tne report 1 issued by Doctor Florence H. Daniel- 
son and Doctor Charles B. Davenport, after their careful inves- 
tigations: 

"We may find one case of feeble-mindedness wherein the 
individual is cruel and keen in the pursuit of mischief, but unable 

1 "The Hill Folk," published August, 1912. 



400 THE EXCEPTIONAL CHILD 

to learn, and another case in which he is kind and learns quite 
readily, but is shiftless and devoid of judgment, and the ability 
to apply his knowledge. Such instances seem to indicate that 
these different traits which characterize the types of feeble- 
mindedness may furnish a truer basis for a theory of inheritance. 
One combination of certain traits presents one sort of feeble- 
mindedness and another combination another sort. Working on 
this hypothesis, it may be possible to obtain from two parents 
whose defects are due to different traits (or the lack of them) a 
child who may be superior to either parent as a member of 
society. For instance, if such traits follow the Mendelian prin- 
ciple, a man who is industrious but apathetic and unable to con- 
nect cause and effect (i. e., lacks good judgment) so that he can- 
not compete in business, married to a shiftless woman who is 
keen and shrewd, even to a vice, may have offspring in which 
the father's industry and the mother's mental ability are com- 
bined so that they may be superior to either parent. For if the 
feeble-mindedness of the father's type and that of the mother's 
type are gametically independent and each recessive to the 
normal condition, they may produce normal children. 

"The analysis of the data, then, gives statistical support to 
the conclusion abundantly justified from numerous other con- 
siderations, that feeble-mindedness is not an elementary trait, 
but is a legal or sociological rather than a biological term. Fee- 
ble-mindedness is due to the absence now of one set of traits, 
now of quite a different set. Only when both parents lack one 
or more of the same traits do the children all lack the traits. 
So if the traits lacking in both parents are socially important, 
the children all lack socially important traits, i. e., are feeble- 
minded." 

This definition of feeble-mindedness is most interest- 
ing, especially when compared with the definition given 
in Chapter IX of this book, basing its presence on the 
absence of "common sense." Nevertheless, the discus- 
sion just quoted would seem to show that it refers to a 
condition so vague and obscure that it may be applied 
to a very large number of persons in various walks of 



EUGENIC CONSIDERATIONS 401 

life. 1 The author is not sure but that many rather 
eminent characters, men and women who have contrib- 
uted vitally to the sum total of human achievements, 
would fall under the definition of feeble-mindedness as 
"a legal or sociological term," having been quite inca- 
pable of commercializing their genius, and having been 
total failures as business assets. Besides, the discussion 
shows how much theory there is still in eugenics, and 
that we have not yet been able to marshal all the facts 
and to organize them in the form of clearly denned and 
universally applicable natural laws. 2 

Collection of Data. — The case of the feeble-minded 
and the mentally defective has in recent times been so 
sensationally and loudly discussed that many people 
have been led to think that the science of eugenics is 
mainly concerned in preventing the breeding of the 
feeble-minded. The small feeble-minded portion of our 
population has been held so close to our eyes that it 
looked big enough to crowd from our vision the many 
other problems of a eugenic nature. The broad prac- 
tical possibilities, however, embrace constructive measures 
for mankind as a whole, not merely remedial provisions 
for the plainly unfit. 

We are warned that feeble-mindedness and other 
mental defects cause crime and prostitution, and that 

1 Compare with these statements the utterance of Superintendent 
Johnstone, of the Vineland (N. J.) Training School, who said in a dis- 
cussion at the New Jersey Conference of Charities and Correction, in 
1916: " We were told we must look out for immediate facts, because a 
lot of people are called feeble-minded who are not feeble-minded. We 
were told this morning that many who were called feeble-minded by the 
supposedly best psychologist in the country were helped by glasses." 

2 A careful study of the "Medical Symposium" will reveal some of 
the fundamental facts of hereditary transmission in terms of biological 
function. 



402 THE EXCEPTIONAL CHILD 

consequently we must prevent the mentally defective 
from propagating their kind. But the statistics which 
are given us to show the danger of transmitting unde- 
sirable traits are somewhat doubtful. At one time the 
author saw a chart in which the family history of two 
inmates of a certain lunatic asylum were supposed to 
be traced. The two were found to be related to each 
other a few generations back, and about 1,000 progeni- 
tors and relatives were charted. They were neatly 
classified as having been worthless in one way or another, 
having been feeble-minded, insane, inebriate, paupers, 
or what not. The question arose how in the world the 
investigators had been able to obtain information relia- 
ble enough to make the diagnosis of so many dead per- 
sons for tabulation. The manner in which such cases 
are tabulated is explained in a book which has become 
well known of late, and in which two branches of the 
family of a certain youth of Revolutionary times are 
traced. It says there: 1 

In determining the mental condition of people in the earlier 
generations (that is, as to whether they were feeble-minded or 
not) one proceeds in the same way as one does to determine the 
character of a Washington or a Lincoln or any other man of the 
past. Recourse is had to original documents whenever possible. 
In the case of defectives, of course, there are not many original 
documents. Oftentimes the absence of these where they are to 
be expected, is of itself significant. For instance, the absence 
of a record of marriage is often quite as significant as is its 
presence. Some record or memory is generally obtainable of 
how the person lived, how he conducted himself, whether he 
was able to make a living, how he brought up his children, what 
was his reputation in the community; these facts are frequently 
sufficient to enable one to determine, with a high degree of 

iGoddard, "The Kallikak Family." 



EUGENIC CONSIDERATIONS 403 

accuracy, whether the individual was normal or otherwise. 
Sometimes the condition is marked by the presence of other 
factors. For example, if a man was strongly alcoholic, it is 
almost impossible to determine whether he was also feeble- 
minded, because the reports usually declare that the only 
trouble with him was that he was always drunk, and they say 
if he had been sober he would have been all right. This may 
be true, but, on the other hand, it is quite possible that he was 
feeble-minded, also. 

After some experience the field-worker becomes expert in 
inferring the condition of those persons who are not seen, from 
the similarity of the language used in describing them, to that 
used in describing persons whom she has seen. 

It is obviously impossible to consider this method of 
gathering information as scientifically reliable. The 
definition of mental defect is yet too vague; the meth- 
ods of determining the mental status of an individual 
are yet in the process of development. We know too 
well how easily misjudged a man is by his neighbors, 
and how indistinct the memories even of our own de- 
parted friends become in our minds after a short time. 
If we feel that we know something more definite about 
historic figures like Washington and Lincoln, it is be- 
cause we have, of course, considerably more documen- 
tary information of them than we have of the obscure 
dweller in the obscure village. But history often re- 
verses the judgment of contemporaries, and the inside 
history of even such heroes is sometimes very different 
from what is popularly known. 

We can never have anything like a reliable history of 
an individual and his family until we have ample and 
trustworthy vital statistics enforced by law, and suit- 
able methods of testing and diagnosing the mental and 
moral status of the living. 



404 THE EXCEPTIONAL CHILD 

The author's own investigations have taught him 
great caution in accepting such family charts as proofs. 
We are not quite sure yet of the best methods of test- 
ing the mental caliber of the living. Many of those 
who have been put down rather low in the scale of in- 
telligence will surprise us by becoming perfectly useful 
citizens as soon as their economic conditions, their en- 
vironment in general and, with this, their opportuni- 
ties, are improved. To judge the dead who can no 
longer defend themselves or give counterproof after 
relief from pressure, on the basis of unprovable reports, 
seems very unfair. Many a person has been ostracized 
in his community because he was different from his 
Philistine neighbors. He became a failure in life 
through disappointment. Possibly he sank to the level 
of despair and self-effacement through drink to escape 
in forgetfulness the unsurmountable prison walls which 
his narrow-minded neighbors had erected around his 
aspiring soul. We should think twice before we judge. 
To put down, as has been done in scientific articles, 1 a 
humble family living in a shack as mentally inferior to 
their wealthy neighbors living in a well-appointed house, 
is invidious. The successful neighbor may have been 
an unscrupulous crook in his business methods, and the 
dweller in the shack may have been one of his victims. 2 

Constructive Methods. — Evidence has been evolved 
that in the living generation delinquency, pauperism, 
inebriety, and other vicious conditions can be controlled 
and eliminated by improving the environment and by 
socially constructive methods of uplift. Almost all our 

1 Cf. "The Village of a Thousand Souls," The American Magazine, 
May, 1913. 

2 Cf. also Chapter II, "The Problem of Efficiency." 



EUGENIC CONSIDERATIONS 405 

misfits and failures can be saved if we give them the 
right chance. It would therefore seem reasonable to 
admit that at least a large percentage of the unfortu- 
nates, now set down in these family histories as derelicts 
and degenerates, were in reality the victims of a vicious 
environment and of lack of opportunity. 

Stories of tainted heredity, holding up to our eyes 
the horrors of degeneracy, have had a depressing effect 
upon multitudes of sensitive men and women. It is 
time that we realize the world is not any worse to-day 
than it has been at any previous time. Yea, we are 
growing better. It is well enough that our social con- 
science has been awakened to a clearer appreciation of 
its function. It is needful that we face the dangers to 
body and soul with unflinching and seeing eyes. It is 
encouraging that we have learned to understand the 
right of children to be well born and to be well brought 
up. 

But it seems wisest not to dwell exclusively on the 
negative and pessimistic side of things. Methods of 
preventing evil do not necessarily mean prohibitive and 
restrictive measures. There is positive, constructive, 
uplifting work to do. 

An appeal to the good that is in men is better than to 
concentrate on punitive and restrictive laws. Teaching 
the young the beauty and wonder of sex and procrea- 
tion, the sweetness of fatherhood and motherhood, is 
more conducive to morality and to the securing of 
proper matings and sound offspring than to teach a 
crude and repulsive sex hygiene. To encourage early 
marriages of the fit and strong, and to convince these 
that it is their privilege to propagate the race instead of 
allowing the weak to outstrip them by a preponderant 



406 THE EXCEPTIONAL CHILD 

number of their offspring, leads more effectively to a 
rejuvenation of the race with every incoming generation 
than a minute regulation of the physical requirements 
for the marriage contract. 1 Bettering the economic and 
environmental conditions of the masses, improving our 
educational systems, developing the social conscience, 
giving each new-born babe his chance in life, will be 
surer ways to prevent degeneracy and crime than a 
morbid study of the mysterious laws of heredity and 
the clamor for sterilization laws to be applied on a large 
scale. 

The laws of heredity in their application to human 
beings are still quite obscure and are pre-eminently a mat- 
ter of exact scientific investigation. They cannot yet be 
popularized. Their study may bring many surprises, as 
it has already done. And we cannot, with the -best of 
intentions and the most carefully worded statutes, con- 
trol heredity. We are not prepared to apply the meth- 
ods of the breeder to human matings, human intelli- 
gence, human sentiments, human souls. 

Practical Eugenics. — Even with what we know of the 
conditions affecting marriage and procreation, there is 
enough sound counsel to be given to prospective spouses 
and parents. It is well that either partner to the mar- 
riage vow enters into this sacramental state with a full 

1 Very pertinently Florence Hull Winterburn says in the chapter on 
defective children in her book, "The Children's Health": "Most adults 
consume each day all the force nature supplies to them. They have no 
reserve strength to employ in parenthood. How is it possible for jaded, 
nervous, feeble men and women to provide that abundance of rich blood 
and spiritual vitality demanded by this supreme function? The off- 
spring they persist in having get merely the dregs of their exhausted 
life, and must be nursed and coaxed by every device known to medical 
science to sustain the burdens of an existence they scarcely deem worth 
the while." 



EUGENIC CONSIDERATIONS 407 

realization of the responsibilities implied in it, not only 
to themselves mutually but to the expected offspring 
and to society, so that the future generations — toward 
whose number they will contribute — may be composed 
of healthy and sane individuals, effective and spiritually 
well qualified for their functions as citizens and members 
of human society. 

Of course there are hereditary factors. When there 
are diseased conditions, mental weaknesses, emotional 
abnormalities in either partner, caution is advisable. 
An otherwise sound constitution may have been weak- 
ened by inebriety, or inebriety may point toward some 
inherent weakness of body or character. There may 
be venereal disease. Either partner must realize that 
he or she does not only marry the woman or the man, 
but the whole family — socially, and as representing a 
certain level of culture and life habits, but also with all 
the antecedent physical and mental endowments and 
defects which will affect their offspring in their cumula- 
tive, combined, or selected traits. Headlong marriages, 
contracted in a spirit of recklessness or momentary pas- 
sion, are doomed to produce unhappiness and to preju- 
dice the career of the children born from them; they 
are the prime cause of the divorce evil, which is increas- 
ing in magnitude, and which places the children of these 
unions in the most precarious positions. Flirtations, 
unguided passion, are poor guides in selecting life part- 
ners. To allow ulterior motives, considerations of 
wealth, rank, title, influence, to determine the choice 
of husband or wife, is one of the greatest crimes against 
humanity and the future generations that can be com- 
mitted, be it through the parents' own traditional preju- 
dices, or through the young people's folly. If parents, 



408 THE EXCEPTIONAL CHILD 

in their educational policy in the home, will take care 
that the natural instincts and tendencies of childhood 
and youth are preserved in their healthy integrity; if 
love reigns supreme in the home — love of that pure type 
which binds parents and children together with bonds 
that can never break — then, in the children's emotional 
evolution, in their sexual relation, affection will be the 
determining factor. And love, as has been said before, 
is after all a safe guide in marital selection. 

Many of the hereditary influences, such as may be 
difficult of control, can be overcome by sanity and 
proper hygienic regime during pregnancy. 

Early Marriages. — It has become a custom in this 
country to discourage early marriages. The higher edu- 
cation of women, which keeps many in colleges away 
into the third decade of their age; the economic inde- 
pendence of women who find lucrative employment, 
which they are unwilling to sacrifice for the duties of 
married life; and a general tendency toward lengthen- 
ing the period of "freedom," have contributed their 
share to this condition. On the part of the young man 
it is the desire to place himself firmly on the ground of 
economic independence in the fierce struggle for exist- 
ence which prompts him to postpone the founding of a 
family, with the added responsibilities. These causes 
may be understood, even though they are deplorable. 
Another less reasonable cause is the disinclination of 
young people to put up with a modest manner of fife in 
the beginning. They do not know or care for the joy 
of building up, by happy co-operation, a home of their 
own which is distinctly the expression of their own evo- 
lution in the married state. They think that the style 
and luxury which some of them have enjoyed in their 



EUGENIC CONSIDERATIONS 409 

parents' home are indispensable to their happiness; they 
want to begin where the old folks have left off. 

But postponement of marriage is a sad thing in many- 
ways. The first fire of youth is burnt out when the 
young man finally takes his bride into their common 
home; life has already been tasted at many points, and 
not always in the purest sense. The physical develop- 
ment of the woman who waits to be married late is 
prejudicial to childbirth, and at least the first child is 
the sufferer of the consequences. 

As soon as marriage is consummated home life begins. 
We shall consider the "eugenic" conditions of home 
life, and the circumstances which determine a healthy 
growth of childhood in the home, in the next chapter, 
briefly, at least. 



CHAPTER XX 
HOME LIFE AND HOME EDUCATION 

It is, of course, impossible to treat exhaustively in 
this book-all the problems under this head. Only a few- 
salient points can be mentioned, leaving the bulk of the 
argument to other opportunities. 1 

Unwelcome Children. — One of the saddest spectacles 
in any home is the unwelcome child — the child that 
came after unsuccessful efforts were made to abort it. 
It is invariably doomed to develop unwholesomely in 
some way. While, under very special circumstances, it 
may be permissible to prevent conception (there is a 
movement among a number of well-known and well- 
meaning sociologists to have "regulation of births" by 
preventive measures legalized), it is nothing short of 
criminal to kill the budding life. Artificial abortion is 
justly placed on the statute-books of all civilized com- 
munities as a crime against life and society. It is un- 
fortunate enough when the condition of the mother 
should cause still-births and miscarriages. As a matter 
of fact, these conditions may affect the physical and 
mental health of the children who are born after such 
birth-failures. 

The percentage of reported still-births and miscar- 
riages is higher than may be thought, and it must be 

1 Parts of this chapter, in a somewhat different form, were first pub- 
lished in The Mother's Magazine. 

410 



HOME LIFE AND HOME EDUCATION 411 

remembered that most of the artificial killings of em- 
bryos, and of abortions, are kept secret. This is a dis- 
grace to modern civilization. 

No one ought to enter the state of matrimony who 
is not willing and anxious to take the responsibility of 
married life, of parenthood. In choosing a husband or 
a bride, be sure that your prospective life partner loves 
children and wants children. Marriage is not merely a 
physical union of the sexes; it is a sacred union for the 
propagation of the race in which both partners* should 
wish to contribute what is best in their physical, mental, 
and ethical selves. 

"Marriage is a matter of more worth 
Than to be dealt in by attorneyship." 

— Henry VI. 

The Sacrament of Matrimony. — In other words, it is 
infinitely more than a mere civic contract. It is as much 
a spiritual union as it is a union of bodies and hearts. 
Shakespeare, like many others, calls "God the best 
maker of all marriages"; and truly, were it not for a 
divine spark to electrify the emotional relations between 
husband and wife, these relations were little more than 
animal passions. The very purpose of matrimony, 
physiologically speaking, viz., the propagation of the 
human race, the production of offspring, is in its very 
essence an approach toward the divine privilege of cre- 
ativeness. The sweetness and the miracle of this ever- 
new creation of human life, full of promise and poten- 
tialities, can never be expressed in its completeness by 
mere words. It can only be felt, and constitutes that 
sacred bliss which makes human love and marriage the 
sweetest thing on earth; that which sanctifies the nup- 



412 THE EXCEPTIONAL CHILD 

tial relations as much as it does the love of parent for 
child. It is indeed difficult to say which is the holier 
and more felicitous thing — the love of parent for child 
or the love of husband and wife. They are both one, 
one intimately interwoven with the other. Milton hails 
"wedded love" as the "mysterious law, the true source 
of human offspring" — for wedded love has this distinc- 
tion from sexual license that it recognizes the full dig- 
nity and the happy but awe-inspiring responsibility of 
this union of man and woman. Entering upon it, the 
married couple at once assume grave functions, not only 
toward each other but toward the expected offspring, 
and by force of these parental functions, they assume 
a tremendous obligation toward humankind, present and 
future. Sexual license dreads the consequences, or 
ignores them. With it children are an accident to be 
avoided. In wedlock the advent of the child marks 
the completion of happiness. 

Health of the Prospective Mother. — It should not be 
necessary to assert with special emphasis that women 
must, during their pregnancy, endeavor to secure for 
themselves the most auspicious hygienic conditions. 
Too many, alas, enter into this state poorly equipped 
physically. From a circular letter of the "National 
Consumers' League" the following two paragraphs paint 
the picture of starved girls who, when plunging them- 
selves into the current of love and marriage, will be apt 
to starve their offspring in the womb: 

"Sometimes I just long for a good thirty-cent meal," said a 
girl who was earning $6 a week. "But I never have the price 
in my pocketbook. I get so tired of those fifteen-cent dinners 
year in and year out, that I think often I'd rather not eat at 
all." 



HOME LIFE AND HOME EDUCATION 413 

This hopelessness — the feeling that expenditures must forever 
be hedged about by petty savings, stands out most prominently 
in stories gathered from girls in stores and factories. Their bud- 
gets mirror starved and dreary lives. 

It is, of course, not only the lowly girl who is thus 
doomed to prejudice her offspring, but many mothers 
of means injure their vitality during this most impor- 
tant period. Gay women who will not forego the plea- 
sures of the social swirl; pampered women who never 
give their bodies a chance to function actively and vig- 
orously will be responsible for the production of chil- 
dren bearing the stigma of weakness from birth. Proper 
nutrition and exercise, the following of the most patent 
laws of health, are. necessary to secure for the unborn 
child such chances as will grant him a normal and effec- 
tive existence. 

Naturally the emotional and mental condition of the 
mother during pregnancy plays a very important part. 
Anxieties, stress of emotion, excitements, fears, and 
other psychic influences leading to hysteria, neurasthe- 
nia, and general nervous depletion are responsible for 
much unhealthy child life. An unhappy mother may 
have children predestined for unhappiness. 

The father's part during this period is to do all in his 
power to remove from his wife's path all those obstacles 
which would cause ill health and unhappiness. He has 
two lives in trust, and he should be conscious of his 
wonderful privilege to watch over the mystery of crea- 
tion coming into his own life — the rebirth of his own 
self blended in sacred communion with the personality 
of another self dear to him. 

All these things may sound commonplace and self- 
evident. The author wishes they were. 



414 THE EXCEPTIONAL CHILD 

Care in Labor. — Much and often irreparable damage 
is done at the birth of the child, through unskilful han- 
dling. The evils of midwifery are only beginning to be 
controlled, through licensing midwives after examining 
them for fitness. Poorer mothers will for some time 
to come have to rely upon midwives, perhaps, but some 
method should be found to regulate assistance in labor 
by proper legislation, through the agency of boards of 
health, with the obligation of immediate registration of 
births. Infection in labor, on account of lack of cleanli- 
ness, transmission of disease from assistant to the par- 
turient or to the child is all too frequent. Ophthalmia 
neonatorum, the dreaded disease dooming a child to 
blindness, is as often the result of this cause as of vene- 
real infection of the mother herself. 

It will always be best to place a prospective mother 
in charge of a reliable physician and obstetric nurse. 
Physicians will have to exercise great care in employing 
and supervising the nurse; it is the author's experience 
that much damage is done by lack of judgment and 
conscientiousness on the part of the nurse — often en- 
tirely unknown to the physician in charge. The mother 
rarely has the physical and mental strength to resist the 
insidious influence of an injudicious nurse, and is too 
much at the latter's mercy to have the courage to com- 
plain to physician or husband. It is the husband's plain 
duty to do all in his power to secure for wife and child 
the best possible assistance at this critical moment. 
Often it is most advisable to transfer the mother from 
the home to a well-directed maternity hospital. 

Of the care of mother and child after the first weeks 
of confinement, much has been written. It is unneces- 
sary here to duplicate what can be easily read in books 



HOME LIFE AND HOME EDUCATION 415 

intended as mothers' guides, and written by reliable 
authors, like Kerley, Holt, and others. But it may be 
suggested that from the date of the child's birth the 
family physician should be considered a steady and con- 
fidential adviser, not merely to be called in when the 
child seems sick, but to regulate, with the idea of pre- 
vention, a child's health life continuously. 

A Healthy and Happy Home Life. — No " eugenic" 
childbirth is possible where there is not a healthy, happy 
home life. It goes without saying that the husband is 
one of the factors in the making of this home life. But, 
after all, it is woman who is the home-maker. She de- 
termines the spirit of the home. She is the keeper of 
her husband, whom she makes or unmakes. It is usu- 
ally wrong to place the exclusive blame of a husband's 
erring ways to his debit — man is wax in the hand of 
woman. The' worst man will, if his woman cares, fight 
the battles of life for her, and will be swayed in his 
actions and emotions by her praise or disapproval. 
Since women have sought so much activity outside of 
the home; since they have decried the home duties as 
menial and as drudgery; since the individual home has 
given way, in so many instances, to life in "family 
hotels," which are, in their way, as detrimental to the 
sacredness of the hearth as are tenements and slums, 
home life has begun to depreciate. Even the ordinary 
apartments are not homes for children; many landlords 
distinctly bar children from their premises, or restrict 
their play to common nurseries. Most homes, for that 
matter, are not so conducted that they offer the child a 
real home. They are homes for the conveniences of 
adults; the children are often really in the way, and 
have to be put out of the way, in the corner, or to bed, 



416 THE EXCEPTIONAL CHILD 

so that the adults may have their life opportunities. 
And when the adults want to go out, unless they can 
hand over their children to some more or less reliable 
and competent relative, older child, or employee, they 
drag them along to places of amusement and noise, 
bringing them home at all hours of the day or night, 
exposing them to a host of physically and mentally 
unhygienic conditions. 

The Profession of Parenthood. — Parental functions 
have rarely been considered in the light of professional 
duties. Because every one may be a parent, the dis- 
charge of parental functions has never impressed people 
as being a serious business which must be learned like 
any other business. And yet, upon a proper discharge 
of these duties depends not only the happiness of mil- 
lions of homes, the fate of hundreds of millions of little 
children, their very life and death, their morality or 
criminality, but even the future of all the generations 
to come, the future of our race on the earth. 

There seems to be an implied supposition that as 
soon as a man or a woman becomes a parent, the ability 
to deal with the new-born child will come to them by 
special revelation or by instinct. It is true there exists 
an instinctive predisposition in women to be helpful to 
tender babes; nature has indeed endowed them, like the 
mothers among the brute creation, with those qualities 
that enable them to understand intuitively the needs of 
children better than does the average man. But this 
instinct is of a somewhat general character; it shows 
itself as a matter of emotion rather than of intellect. A 
woman may devote much tender care to a child, with 
the motherly instinct which is her natural privilege, and 
yet injure her charge more than it would have been 



HOME LIFE AND HOME EDUCATION 417 

injured had she left it entirely alone. In our complex 
conditions of life, instinct unguided by experience and 
understanding is apt to be misleading, especially as an 
adult has acquired so many artificial and conventional 
habits that natural instincts often manifest themselves 
in a vitiated form. 

There is another way in which women are, in a gen- 
eral manner, preparing for the motherly duties that 
may await them — by observation and absorption of what 
they see their elders do. Even in their doll play, which 
is another form in which the native instinct asserts it- 
self, little girls practise many maternal duties, and it is 
to be deplored that little boys are not rather encour- 
aged than discouraged to play with dolls, also. For it 
is a great mistake to think that the father's tenderness 
and educational co-operation can be spared in the 
bringing up of children, or that he needs less prepara- 
tion and enlightenment in regard to his sacred functions 
than does the mother. 

Yet observation, absorption, and imitation do not 
suffice for apprenticeship in any line of human endeavor. 
He would be a genius, indeed, who would by imitation 
alone be able to make a perfect shoe, or plan a bridge, 
or produce a truly great work of art. There are princi- 
ples to be studied, there is need of guidance and sys- 
tematic practice, there must be purposeful effort on 
the basis of the experience of teachers. 

Frobel suggested that every girl should be expected 
to take a course somewhat along the lines of kindergar- 
ten training, to prepare for motherhood. One of the 
first schools having for their special object the training 
of nurses and mothers was founded in England — the 
" House of Educators," in Ambleside. The "Frobel- 



418 THE EXCEPTIONAL CHILD 

Haus" in Berlin has long ago introduced similar courses. 
During the last two or three decades the new impulse 
which is due to the child-study movement has had the 
result of arousing many parents in different parts of the 
civilized world to a clearer appreciation of their duties 
and responsibilities, and also of their sad lack of prep- 
aration for their sacred functions. Parents' and moth- 
ers' societies have sprung up and give promise of much 
helpful work. Lately a school of mothercraft has been 
established in New York. Chicago University has quite 
recently offered a college course in motherhood. And a 
new literature has sprung up intended to teach to pros- 
pective parents the gospel of the child. 

Fundamental Realities.— " The home is for the child/' 
said Reverend George R. Merrill, of Minneapolis, at a 
meeting of the Congregational Club of Minnesota, some 
years ago. "It is not fashioned by statute. It is such 
a union of a man and a woman that in very truth they 
have become a unit. The child is the expression and 
exponent in miniature of realities actually joined in 
such a union." 

These realities are hereditary and environmental. 
The problem of heredity has already been discussed in 
these pages. Only a few things may further be said 
here under this heading. 

Hereditary Elements. — It has been wittily said that a 
child must be educated a hundred years before his birth. 
This seeming paradox points to the vast influence of 
transmitted elements. A child is the last link of a 
chain the beginning of which is lost in the dim past. 
He will reproduce race characteristics, national pecu- 
liarities, family traits. They are all born with him. 
In the different issues from the same stock the mixture 



HOME LIFE AND HOME EDUCATION 419 

of elements will vary, producing a multitude of possi- 
bilities of which the separate individuals will be the 
exponents. In fact, no child is born into this world 
under exactly the same conditions as another, even 
though he be born from the same parents. Each new 
birth represents a different period in the parents' life, 
and new conditions of the conjugal union. Some of the 
hereditary elements are physical, others are emotional 
or mental. It is sometimes almost amusing to observe 
how faithfully children revive in their young lives the 
peculiarities of their progenitors — the nervous twitching 
of the eyes belonging to some great-aunt; the form of 
the nose is characteristic of a grandfather; the smile is 
the mother's; the quick temper the father's, and the 
genius an uncle's. We inherit from our ancestors ten- 
dencies and potentialities of infinite variety. In nature 
there is no equality — there is the greatest possible in- 
equality. 

As parents we must be constantly on our guard lest 
our life habits have a disastrous effect upon our chil- 
dren's future. Many fathers whose nervous system 
has become depleted in the mad rush for gain have 
left a pernicious inheritance of defectiveness. Intem- 
perate habits in the parents may result in constitutional 
weakness in the offspring. There are many mothers 
suffering from chronic fatigue: be it from overwork in 
the home or in service ; be it the effect of overstimulating 
their nervous system by overstudy or by the excitement 
consequent upon the pursuance of amusement and 
"social duties" — their children will pay the penalty of 
their mothers' folly or misfortune. 

Apart from those habits and conditions of the parents 
which have a hereditary significance, there are those, 



420 THE EXCEPTIONAL CHILD 

and their number is legion, which are continued by 
imitation. Children are immensely imitative and sug- 
gestible. Every word we speak, every expression of 
our face, every gesture we make — in fact, all we do finds 
a ready echo in the child's receptive mind. It has been 
justly claimed that many a trait which we thought 
hereditary was really acquired by imitation. This leads 
over to the second group of influences, those of environ- 
ment. 

Environmental Factors. — Under environment we un- 
derstand all those impressions which the child receives 
after birth, and which help in shaping his character. 
They are generally divided into two classes: those that 
are conveyed to the child with a direct educational pur- 
pose, such as teachings and admonitions at home and 
in school, and those which affect the child without such 
direction. The silent, undirected influences of the more 
or less passive environment — the influences of example, 
of conditions, of traditions, of experiences — are, as a 
rule, much more numerous and much more effective 
than the other. Even in the educational efforts of 
parents and teachers, there is a large admixture of in- 
voluntary elements so that no hard-and-fast line can be 
drawn between the two groups of environmental influ- 
ences. 

Let us be quite clear about the extent of these influ- 
ences. A picture in the nursery may have as much 
formative effect upon the child's imagination as an 
actual scene witnessed in the street, or a visit to the 
circus. The parents' lodgings, the streets traversed in 
the daily walks, the locality where the parents reside; 
their immediate and more distant surroundings; the 
State; the country; — and starting again at the home 



HOME LIFE AND HOME EDUCATION 421 

along a different line — the parents, the brothers and 
sisters, the servants, aunts, uncles, relatives, and kins- 
people in general; friends and acquaintances; the milk- 
man and the grocer; the people in the street, the citizens 
of the State — all these elements help to mould the child's 
soul, and were it merely by their passive presence and 
example, not to speak of active influences. All these 
factors have a peculiar educational significance — they 
constitute the child's setting. The spirit of the home 
and the parents' relation to the world of human en- 
deavor about them; the habits and conventions of the 
people; the moral and intellectual atmosphere of the 
community, all leave their mark upon the impression- 
able mind of the growing child. This demonstrates very 
forcibly that while the child can never be too cautious 
in the selection of his parents, the parents in their turn 
can never be too solicitous in the selection and improve- 
ment of the environment in which they place their child. 
They must naturally have a deep interest in all public 
affairs touching upon public welfare and the healthy 
condition of the community in which they live, since 
every tree planted in a public park, every advancement 
in the public education and administration — or every 
wretched outcast met with in the public streets, every 
evidence of iniquity or corruption in the management 
of public affairs — will influence their child's salvation. 
To any one who wants to have a clear-cut pen-picture 
of the machinery back of our politics; of the bribery, 
corruption, and graft which are so unhappily character- 
istic of community life in our great republic (and for that 
matter, in other countries quite as much); of the petty 
selfishness that rules our so-called Christian civiliza- 
tion, the author recommends the reading of a powerful 



422 THE EXCEPTIONAL CHILD 

little story published in the July, 19 15, issue of McClure's 
Magazine, "The Honesty of Honest Tom," by the well- 
known writer, Lincoln Steffens. We are living in a 
commonwealth in which it requires the most strenuous 
efforts of many broad-minded people, organized in the 
National Child Labor Committee, to fight — more or 
less successfully — the constant practice of many of our 
manufacturers and business men to exploit child life in 
the most ruthless manner. The revelations of the work- 
ers of this organization have been appalling. Do we 
want to save children from becoming diseased and 
broken down before their prime, to pile up the refuse- 
heap of human society? Do we want to rely upon or- 
ganized society to establish and maintain charity and 
correction measures to deal with the victims of bad 
economic conditions and of exploitation by unscrupulous 
employers ? 

This is part of the "environment" in which our chil- 
dren grow up. Is it not the solemn duty of every parent 
to give his and her most consecrated effort to wipe out 
social iniquity and to purge society of those germs of 
physical, mental, and moral disease which are so likely 
to affect their own children? Alas, in only too many 
cases parents themselves are exploiters of their chil- 
dren's bodies and souls; and the deceptions they prac- 
tise, the lies they tell and make their children tell, are 
not conducive to implanting in the youthful minds a 
love of truth, integrity, and uprightness. The moral 
principles of the average home are rather hazy. 

Children Are Not the Property of Their Parents. — 
The old notion that children are the private property 
of their parents; in other words, that parents have 
absolute control over them — whether they are to go to 



HOME LIFE AND HOME EDUCATION 423 

school or not, as to what profession the children must 
choose, whom they are to marry, what they must be- 
lieve and profess, etc. — this idea is an exploded theory. 
There are such things as children's rights, rights quite 
inalienable, and among them are life, liberty, and hap- 
piness. Since the days when a Roman father could con- 
demn his new-born babe to death if it displeased him, 
the recognition of these rights has gradually become 
incorporated in the statute-books of nations. Compul- 
sory education laws, child-labor laws, and the like, are 
among the measures most notably intended for the pro- 
tection of helpless children. We may educate and 
counsel, guide and inspire, but all our efforts must be 
directed toward enabling our children to become inde- 
pendent and self-reliant, toward developing their native 
individuality which we are bound to respect. We have 
no right to force our child into conformity with our 
own preconceived notions and prejudices; to predestine 
our child for a career which strikes our fancy or appeals 
to our individual standard, or even to the popular 
standard, of "practical," conventional profitableness; 
but we must endeavor to discover his natural bent, and 
develop the child along the line which nature has pointed 
out for him. Through heredity and imitation the child 
will anyway be somewhat inclined to reproduce his 
parents' type in a measure. But we may not implant 
in the plastic soul of the young our own opinions, likes, 
and dislikes; we must studiously avoid prejudicing the 
child, and must give him the freedom to form his own 
opinions and individual attitude, and must help him to 
develop that strength of character which is needful for 
the maintenance and manly defense of a conviction 
which is the result of spiritual growth. We can never 



424 THE EXCEPTIONAL CHILD 

hope to transmit to him in their fulness those spiritual 
realities which have become powerful in our own lives, 
as the composite result of our strivings for perfection. 
All we can do is to imbue the child with the same long- 
ing for perfection, with the same love of the beautiful, 
the true, and the good, which has inspired us to form 
those ideals which give purpose to oui own standard 
of excellence, and which may lead them perchance to 
establish a higher, nobler, more enlightened standard 
than ours. Every new generation stands in need of ad- 
vanced ideals so that the progress of the world may 
continue. 

Individualization in the Home. — To do justice to our 
children does not mean that we must treat them all 
alike. Quite the contrary. Each child has a very dis- 
tinct personality of his own which must be carefully 
studied and intelligently understood. Even children in 
the same family usually differ widely in talents and 
temperament, in morals and moods, according to the 
varying conditions under which they came into this 
world. By studying their interests, in plays and games, 
in books and studies, in company with others and in 
their occupations, we shall learn to know them. Each 
one wants to be treated in accordance with his own par- 
ticular needs — justice means an adaptation to these 
needs, an adjustment of educational effort to the indi- 
vidual case. Such justice is not a simple thing, and 
truly educational treatment at home cannot be easily 
reduced to a patent formula. The parents' closest at- 
tention and interest are required. If parents would 
give some of the time they devote to the fluctuations of 
the stock-market or of the fashions to a loving observa- 
tion of the fluctuations of the soul activities in their 



HOME LIFE AND HOME EDUCATION 425 

children, they would render a greater service to them 
and to the race at large than by attempting to control 
the price of wheat or by conducting a charity ball. 
Frobel's word, "Lasst uns unsern Kindern leben!" 
means that we must live not only for our children, but 
with them and among them, so that we may enter into 
their very souls and understand the subtle workings of 
their budding minds. Only then can we do them justice. 
Education in the Nursery. — The nursery should be a 
sacred place in every home. Here past and present 
join hands in the growing and maturing of the child. 
In the child of to-day we may observe the gradual un- 
folding of civilizing powers and factors which have been 
at work from the dawn of civilization to the most mod- 
ern phases of human life. The evolution of the indi- 
vidual repeats the experiences of the race. As the sav- 
age man was surrounded by a world of wonders and 
mysteries which he only vaguely divined and which 
filled him with terror and strange longings, so the infant 
finds himself confronted with a world of forces which 
he realizes but indistinctly, and whose indefinite and 
infinite content and extent he learns gradually to reduce 
to symbolic terms, in his own consciousness, through 
language, measurement, organization, co-ordination. 
He learns to grasp the mysteries of his life by grasping 
with his feeble hand the objects which are nearest to 
him — through them he will learn to understand and in- 
terpret the possibilities of the infinite. The nursery is 
a temple in which the divine manifests itself in its eter- 
nal creativeness ; it is a laboratory in which a new soul 
is formed by the thousand and one experiments which 
the child undertakes instinctively to build up a con- 
ceptual world through the medium of his senses, from 



426 THE EXCEPTIONAL CHILD 

the messages which the outside world sends him inces- 
santly along the wires of his nervous system. 

In the nursery the foundation is laid for all future 
education. During the first seven years of his life a 
child assimilates more, "learns" more, than in all his 
subsequent life. Instinctively the child is constantly 
studying, experimenting, storing up experiences, con- 
cepts, and ideas. There is divine wisdom in his activity, 
but ignorant and unsympathetic parents only too often 
counteract his natural instincts when they might do so 
much tojielp them and guide them intelligently. Brain- 
less chatterboxes are often thought bright by foolish' 
parents, and coddled and indulged in; the noisy activity 
of the normal child is often denounced as "naughtiness." 
In the nursery much can be done for the training of 
the observing powers; there should be plenty of objects 
for manual and visual inspection. Children will and 
must touch all things, try all things. Their muscular 
activity must not be checked; it means health and 
knowledge to them. Rather let us dispense with costly 
and superfluous bric-a-brac if we are afraid it will be 
broken. Let us rather sacrifice a cherished piece of 
breakable material than the valuable information your 
child will receive from handling it. Bric-a-brac costs 
only money. Checking the child's instinctive tendency 
for inspection may cost a soul. 

And let us play with the child — not so much by di- 
recting his play, but by entering into his spirit and 
helping him to develop all the tremendous possibilities 
and potentialities of his play instinct. Play symptom- 
atizes the evolution of a child's psyche, in its various 
stages, from savagery to altruistic humanity. Playing 
with dolls, /. i., is not only indicative of the parental 



HOME LIFE AND HOME EDUCATION 427 

instinct in children, but also represents an early stage 
in religious development. The endowing of lifeless 
sticks and bundles of straw or rags with personality, 
the passionate tendency to treat dolls as if they were 
real living beings, is a relic of fetichism and idol-worship 
translated into childish conception. Then there is the 
dramatic instinct of children, reminding us of the dawn 
of poesy and literature. Children will embody, in their 
dramatic fancies, those notions and aspirations which 
they cherish most at the time. They will prefer, in 
the characters of drama and fiction, either those that 
are most like themselves, or represent what they feel 
is wanting in them. This process of involuntary self- 
projection will often aid us in discovering the child's 
real self which he may otherwise try to hide from our 
prying eyes. 

Children's Growth and Health. — The foundation of a 
sound development of the child-soul is a healthy body. 
The child's first right is that of health. Many enough 
children are born into this world burdened with inherited 
body-weakness, suffering from the sins of their fathers 
through generations. To discover such inherited ten- 
dencies is one of the first duties of a conscientious parent 
whose constant assistant and counsellor will be the 
family physician. But there are many more dangers 
to health, and the hygiene of child fife should be care- 
fully considered in the home. 

Children need plenty of light, fresh air, freedom from 
disturbing influences, and proper nourishment. As a 
rule they get little of these essentials, and many of the 
chronic troubles that harass our race are due to the 
irrational practices in the nursery. The statistics of 
infant mortality are sadly instructive. Children are 



428 THE EXCEPTIONAL CHILD 

often treated as if they were merely little men and 
women, small and undeveloped, but essentially the 
same as the adult. The truth is that they are quite 
different, and that their nature varies in often rapid suc- 
cession of periods. Of these periods each requires differ- 
ent treatment. 1 Only a few facts will be mentioned here. 

There are several crises in the development of the 
child. The first is during the infant period. The in- 
fant, owing to the predominance of the vegetative func- 
tions, is subject to gastric troubles, which are generally 
but erroneously attributed to teething. They are due 
to developments in the alimentary tract, which is as yet 
too sensitive not to yield easily to disturbances. Infant 
nutrition is therefore a grave problem. Malnutrition is 
one of the most potent causes of atypical or even abnormal 
development. 

The years from seven to nine are the fatigue period. 
This is the time when the brain has attained almost its 
full weight and when the functional development begins. 
The nervous system now prepares itself for finer adjust- 
ments. This period is characterized by the child's easy 
yielding to mental and physical fatigue and exhaustion. 
Accompanying there is often the anomaly of a dilated 
heart, and quite frequently evidence of cardiac incom- 
petence, such as shortness of breath and readiness of 
fatigue. The danger lies in the extremely insidious 
character of its approach; one of the surest symptoms 
is the appearance of general laziness, which must not be 
punished, as it often is. The child should rather be 
rested and the demands upon his physical and mental 
activity should be temporarily diminished. 

The time of rest granted to the child during this and 
1 Cf. p. 42, Chapter III. 



HOME LIFE AND HOME EDUCATION 420 

the next critical period must not be counted as a loss; 
contrarily, timely rest will secure greater strength dur- 
ing the ascending periods, while irrational stimulation at 
these stages will produce a lasting weakness. 

The period fraught with gravest dangers and char- 
acterized by most remarkable developments is that of 
pubescence and adolescence. It requires special treat- 
ment. It will repay the most careful study, being an 
age of most important physical, mental, and moral 
changes. 

The period of infectious diseases extends from the 
second to the fifteenth year of age. An early recogni- 
tion of the symptoms of infection, and energetic mea- 
sures against the spread of these diseases would mean 
much for maintaining a better condition of public health 
and for reducing the death-rate. But the parent should 
be especially interested in the fact that infectious dis- 
eases are responsible for more other defects leading to 
mental and moral inefficiency than is generally appre- 
ciated. They leave even those who recover in a state 
of debilitation which it requires special efforts to over- 
come. Eye and ear defects are particularly frequent 
after-effects, and these in turn, as has been shown be- 
fore in these pages, lead to much mental and moral dis- 
turbance. Again, impaired hearing may be due to 
nasal-pharyngeal obstructions, enlarged tonsils, and ade- 
noid vegetations, which make normal breathing difficult. 
The "mouth-breather" has a dull appearance and is 
really often dulled in his mental activity. The dele- 
terious effect of cerebrospinal meningitis, infantile paral- 
ysis, and other diseases of this kind, which have only 
recently been recognized as being infectious, are well 
enough known. 



430 THE EXCEPTIONAL CHILD 

It is easily seen how necessary it is to recognize the 
danger-signals in time. Parents, like teachers, must ac- 
quire the art of reading symptoms. They must learn 
to recognize the first indications of disease; to know 
whether the backbone is straight or beginning to show 
a curvature; whether the hearing is normal or impaired; 
whether their children's vision is regular or not (head- 
aches are frequently caused by visual imperfections), 
etc. When the parents' knowledge is insufficient, the 
co-operation of the physician should be secured, who 
indeed ought to play a much more important part in 
education than is yet accorded to him. An ounce of 
prevention is better than a pound of cure. The physi- 
cian, it may be repeated, should appear in the role of a 
counsellor and adviser before a disease has had a chance 
to develop rather than in that of a healer of neglected 
trouble. To understand the development of a child 
and to recognize diseases in their incipient stages, fre- 
quent examinations and measurements of the children 
are a valuable help: slight abnormalities in weight,/, i., 
indicate possible functional disturbance or disease at 
every stage of a child's life, not only in infancy. 

The hygiene of the nursery, using this term so as to 
include children of all ages, is a fruitful field of study 
for parents. Proper nutrition and clothing, ventilation 
and lighting, proper seating and exercise, sense training 
and mental exercise — at home and in school — all these 
require careful attention. 

Abnormal Developments. — Disease, as shown before, 
is often responsible for mental and moral aberrations 
and defects. The results of careful examinations have 
shown that precocious children are, as a rule, heavier 
and dull children lighter than the mean for a given age. 



HOME LIFE AND HOME EDUCATION 431 

Precocious children are usually also taller, have larger 
chests and wider heads than the mediocre and the dull. 
No child whose weight is below the average should be 
permitted to enter a school grade beyond the average 
of his age, except after such physical examination as 
shall make it probable that the child's strength is equal 
to the strain. Physical weakness often produces an 
abnormal mental state. In illness or convalescence, or 
when suffering from hunger and fatigue, most of us are 
more irritable than when we have our full strength. 
Selfishness, untruthfulness, ill temper, and the like, have 
very frequently a pathological basis. This is so char- 
acteristically true that we may in most cases consider 
moral aberration as conclusive evidence of some physical 
defect. Thus, if you should discover in your child some 
sudden moral discrepancy, do not run for the rod, but 
for the physician. But be careful as to what you call 
a moral discrepancy. In nine cases out of ten the so- 
called naughty child is the normal child, and the fault 
lies with you who do not understand him, not with the 
child. The healthy child must be active, noisy, bois- 
terous; beware of the quiet child which is so often 
praised and petted. Refinement and self-control must 
not be forced before their time. There are normally 
quiet children, dreamers, true enough; but the majority 
of quiet children are more or less atypical, subnormal, 
or abnormal. They are either dull, or painfully preco- 
cious, or oversensitive, or diseased, fatigued, or bored. 
Be thankful for your noisy, healthy little savage ! 

Do not try to hasten your child's development; do not 
give him a hothouse culture; do not drive him; do not 
suppress his natural instincts ! Let him be a child as long 
as he may, lengthening the "days of plastic infancy." 



432 THE EXCEPTIONAL CHILD 

Misunderstanding a Child. — How easily is a child 
misunderstood because parents apply an adult standard 
to his doings ! The following may be quoted from an 
article written by Miss Ellen M. Haskell, years ago, to 
illustrate the point (Case 73): 

Reminiscences sometimes disclose the fact that the conduct 
of children is grossly misinterpreted by adults. The writer of 
the last-quoted record relates that one summer day she went 
to a wood-lot on her father's farm to spend an hour in being a 
fairy. To aid her fancy she went without her dress, her neck 
and arms being thus uncovered. On her return she was seen 
by her father, who somewhat sternly ordered her into the house 
to put on her dress. His manner made her feel that she had 
behaved in a manner unbecoming to a modest girl, and an hour 
of grief and shame followed her innocent and poetic enjoyment. 
The readiness to think evil of children arises, in part, no doubt, 
from the great desire on the part of parents that their children 
shall be free from faults and vices, but also in part from a for- 
getfulness of their own youth. A bad motive is attributed to 
a child simply because in an adult a bad motive would underlie 
a similar act, when in truth the child is utterly incapable, intel- 
lectually, of the conceptions involved. 

Truthfulness and Obedience. — Truthfulness and obc 
dience are thought to be the prime virtues of children. 
But if you find your child to be lying to you, do not be 
promptly excited and indignant. First investigate the 
possible cause. Lying may be due to a phase in the 
child's physical development; it may be the result of a 
vivid imagination unguided by the power of discrimina- 
tion. There are many other causes of lying. Perhaps 
your child is timid, and easily frightened; perhaps he 
uses a lie to defend himself against your own violent 
temper. 

And obedience? In the strict sense of this word the 



HOME LIFE AND HOME EDUCATION 433 

child does not owe us obedience at all. Obedience may 
be merely a mechanical response, born of timidity, fear, 
and moral weakness, and not at all a sign of moral 
strength and self-control. At best it is a habit produced 
by enforced practice. It is the parents' business to 
secure their children's ready response and co-operation 
by treating them fairly and squarely and by inspiring 
them with confidence and love. Disobedience is not 
infrequently the result of unsocialized instincts at a time 
in the child's life when these instincts are unorganized 
or disorganized; sometimes it is the product of mis- 
guided independence, and perhaps also an evidence of a 
strong moral will-power. Intelligent and loving treat- 
ment will usually forestall any cases of stubborn insub- 
ordination. A child who respects his parents will respect 
their directions. But parents who do not command such 
respect; those whose course with children is inconsis- 
tent, who forbid to-day what they allowed yesterday; 
who act merely on behalf of their own convenience and 
whim; who may be coaxed, or cried, into yielding, into 
recalling an order, or reconsidering a restriction; when 
the mother is indulgent and the father strict, or vice 
versa; parents who discuss their children and even 
quarrel over them in their very presence; those who 
cannot intelligently lead their children's activities into 
constructive outlets, so that they remain destructive — 
such parents need not wonder that they have to con- 
tend with their children's disobedience, ill temper, and 
ugliness. 

A True Family Government. — The discipline of the 
home must wisely adjust itself to the varying needs of 
growing children. The children must be taken into the 
confidence of their parents in proportion to their devel- 



434 THE EXCEPTIONAL CHILD 

opment of judgment, reliability, and efficiency. Out of 
a monarchical form of government the family must 
gradually emerge into a more democratic organization, 
in which the children are given respectful and sympa- 
thetic hearing, and in which their opinions and votes 
count. Individual conditions will be modifying factors. 
But the underlying principles must be those of freedom, 
mutual regard, and co-operation, on the basis of educa- 
tional insight and adjustment. If parents would think 
less of their own convenience and self-gratification, if 
there were less of hysterical emotionalism in their rela- 
tions to their children, and more consideration for what 
is needed to develop manliness, womanliness, citizen- 
ship, much misery and much perversion would be ob- 
viated. 

Here we have also the measure of inefficiency for those 
homes where economic pressure, shiftlessness, poverty, 
illness, and the thousand and one conditions which pro- 
duce the dissolution of the home spirit and home oppor- 
tunity, deprive the children of the uplifting influences 
which can nowhere be obtained but in the home. How 
many children in this wide and rich country of ours 
have the right kind of home — or, for that matter, a 
home at all ? 

One of the principal requisites for wholesome home 
education is that there be a bond of mutual trust and 
friendship uniting parents and children. A parental and 
filial love which does not blossom out into unrestricted 
confidence is a spurious thing. Parent and child ought 
to need no mediator; no chum or schoolmate or chance 
companion ought ever to stand nearer the child's heart 
than his father and mother. The parents must always 
be their children's best friends; the children must know 



HOME LIFE AND HOME EDUCATION 435 

that they will find sympathy, that they may weep at 
their parents' breast when they have erred, rather than 
be chided and repulsed; that they will be raised and 
lifted up to a higher level from their humiliation by 
confiding in those who have given them life. Parents, 
convert your children as soon as they are old enough 
into your companions and friends, and their new dignity 
will imbue them with a new spirit and enthusiasm which 
will help them to withstand many a treacherous temp- 
tation. Make their lives a part of your own life, right 
along — from the time they were babes in swaddling- 
clothes, when they played their first innocent games, 
when they had their first doll, during the period of their 
school years, through the dangers with which the path 
of adolescence is beset, away into the bliss of their own 
married life. 

During the formative period of school life, secure the 
most cordial and close co-operation with the school 
your child attends. As a rule, parents imagine they have 
fulfilled their duty when they send their child to the 
public school, or to some private school which they have 
selected according to their own best light. But few 
really know, or care to investigate, what happens to 
the child at school, or by what standard they should 
gauge the child's progress. They are perhaps ready 
enough to criticise and find fault, but they rarely co- 
operate with the school in a constructive manner. Yet 
school life often reveals a phase of the child's nature of 
which the parents remain totally ignorant. Home and 
school are two factors in education which can never be 
absolutely separated; their course must not only be 
parallel, but connected and co-ordinated in numerous 
ways. 



436 THE EXCEPTIONAL CHILD 

The True Home Spirit. — In the home, mainly, the 
foundations of an ethical character are laid. "Home is 
not the place where we eat, sleep, and dress to go 
abroad," says Mortimer A. Warren in his valuable little 
book, "Almost Fourteen." "Home is the place where 
we share. We share not only food, shelter, and clothing, 
but we share a common name and blood, and common 
joys and sorrows. We cannot escape it if we would, 
and we would not if we could. The children cannot 
escape their inheritance, and the parents cannot escape 
their marriage vows." 

The spirit of the home is the most potent educational 
factor. Make the home an ideal place, a place where 
love, sympathy, and justice reign supreme, where there 
is an atmosphere of refinement, enthusiasm, moral vir- 
tue, and strength; an appreciation of the beautiful, the 
noble and true; a readiness of moral courage and self- 
sacrifice, of simplicity, uprightness, and charity — and the 
children will absorb and assimilate this spirit, they will 
catch the inspiring infection. 

This true home spirit will inevitably be based upon 
genuine religion. There must be, in the parents, a reali- 
zation of the spiritual life which is the pivot of all phe- 
nomenal life in the soul of man; there must be a recog- 
nition of the eternal facts of creation which link us, one 
and all, inseparably to those infinite powers upon whose 
operation all life depends. Men have called these pow- 
ers by different names, and different modes have been 
established, in the course of centuries, to worship them. 
The most sublime, and at the same time the most lov- 
able of these conceptions of the eternal forces has been 
personified by generations of human souls under the 
sacred name of God. But even though, with some of 



HOME LIFE AND HOME EDUCATION 437 

us, this divine conception has become sublimated into 
an abstraction, devoid of human-like personality — it is 
a reality at once awe-inspiring and wondrously precious. 
It must be like a living presence in the souls of all of us. 
It must be the most potent inspiration to the parent in 
the education of the child. 

The proper religious education of children is still a 
much-disputed problem. We must guard ourselves 
against attempting to imprint upon the plastic soul of 
our children our own individual religious notions, sym- 
bols, and prejudices — which, once implanted there, are 
liable to become encysted, and to be spurious growths, 
obstructions to their individual spiritual development; 
or to degenerate into mere forms and conformities. In 
fine, the religious education of our children is a difficult 
and delicate task, to be undertaken with great care, 
self-restraint, and humility. Yet from the realization 
of a divine presence in the parent will spring the sense 
of reverence which is the corner-stone of all genuine 
religion. Let us take care that we represent to our 
children, in our own lives, a symbol of the divine rela- 
tions. Notwithstanding the psychological fact that the 
idea of a divine fatherhood is but a symbol of the real, 
truly inexpressible, and unfathomable relation of the 
eternal powers to humankind, an idealization of human 
parenthood; this very idealization not only sanctifies 
the parental bond and renders parental influence more 
beneficial and powerful, but it is perhaps the nearest ap- 
proach to a conception of divinity of which the human 
mind is capable. 

Upon such homes rest the welfare and progress of 
the community and the commonwealth. They are the 
strongholds of liberty, purity, and happiness. 



438 THE EXCEPTIONAL CHILD 

Such home ties will remain the strongest of all forever 
and ever with the child. The memory of a happy child- 
hood, of the blissful home, of the beloved father, mother, 
sister, and brother, will strengthen the struggling soul 
in moments of doubt, temptation, and despair. 

Note. — The problem of the boy whose home is only semi -functioning, 
or -who is altogether homeless; of the boy whose play-life is spent in 
"street-land"; whose natural activities are constantly coming into 
conflict with the law and the convenience of the community; — the 
problems of providing proper recreation facilities for the mass of boys, 
of boys' clubs and their functions; of the responsibilities of community, 
school, and church; and the relations of all these factors with the 
problems of juvenile delinquency, backwardness, and failure: are 
treated in a contribution by Mr. Albert B. Hines, under the title, 
" The City and Her Boys," in the appendix of this book. 



CHAPTER XXI 

SCHOOL PROBLEMS 

The problems of the home and the street are re- 
flected in the problems of the school. That our public 
and private schools in their present organization do not 
meet the demands of an individualized training of chil- 
dren has been evident for a long time, not only to out- 
siders, but to the teachers themselves. Their difficulty 
is that they cannot easily overcome the obstacles which 
are in their way when they try to free the schools from 
old traditions. The problem has been plainly stated in 
the first chapter of this book. 

A Powerful Arraignment. — In his little volume, "Idols 
of Education," which contains some very highly sugges- 
tive criticisms of present-day education in school and 
university (some of them unfortunately vitiated by a 
complete misunderstanding of the principles of Frobel 
and the play instinct), Professor Charles Mills Gay ley 
has this to say: 

The boy enters our colleges "a badly damaged article." One- 
sidedly prepared, or not prepared at all, he goes through college 
accumulating courses, but not education; desperately selecting 
studies least foreign to his slender capability for assimilation, 
or most easy to slur, or most likely to turn to superficial ends. 
He is by no means always lazy, nor oblivious that now is the 
chance of his life; but he has no core of knowledge to which 
the facts he fumbles may cling, no keen-edged linguistic or 
scientific tools with which to cut to the heart of the matter; no 

439 



440 THE EXCEPTIONAL CHILD 

memory trained and enriched, no taste, no imagination, no judg- 
ment balanced by frequent trial, no habits of remorseless appli- 
cation. He has bluff but not confidence; he has promise but 
not power. The subjects of his study have not been correlated. 
The goal has been neither discipline nor intrinsic worth. He 
has probably never studied one thing thoroughly. He has not 
been guided; he has not been taught; he has not conquered work. 
He has been distracted; he has been amused. 

Fundamental Verities. — The sad results which Pro- 
fessor Gayley describes are due not altogether to causes 
such as he has in mind. It is perfectly true that the in- 
struction in most of our schools is one-sided and super- 
ficial; that a child rarely uses his intellectual faculties 
with thoroughness. But that is caused mainly by a 
thorough misunderstanding of the needs of the growing 
child mind, and of the process of civilization. 

Civilization has not come to us through books. It is 
the result of the material conquest of the world by man's 
brain. His brain grew with his mastery of the tool. 1 
The old humanistic idea, culture through books, has to 
be materially modified to meet the newer conceptions of 
psychic growth. The child needs vital studies first, those 
that give typical experience. To understand his own 
wild desire to learn real things as against the artificial 
substitutes of the schoolroom, one should read over and 
over Whittier's wonderful study of boy-life, "The Bare- 
foot Boy." Books give second-hand, vicarious experi- 
ence. Reading, writing, and arithmetic are mere inci- 
dentals. They are also tools, like hammer and saw, 
like clay and wood, to be used for self-expression, for 
experiment and production, and as such worthy of care- 

1 Cf. Doctor Paul Carus, "The Philosophy of the Tool," Chicago, The 
Open Court Publishing Company. 



SCHOOL PROBLEMS 441 

ful handling and development. But they represent the 
second, not the first stage of learning. There are many- 
otherwise well-endowed and intelligent children to whom 
these "symbols of reality " will forever remain stumbling- 
blocks, just as there are others who will never be able 
to hit a nail straight on the head, or model a human 
form, or sing a melody without grating on your nerves, 
but who will play with words and write beautiful poetry, 
or soar to the heights of mathematical abstraction. 

Here we have the different types of mind which have 
been so fully treated before that no further explanation 
need to be given here. 

But a realization of these facts must lead to a break- 
ing up of our ordinary school courses, so that each 
individual or group of similarly minded individuals 
will receive differentiated attention, in fairness to all. 
There will then be no hard-and-fast grades and grade 
standards, but groups and group aims, with elastic 
courses allowing of quick adjustment and of an easy 
transition from one to another whenever new develop- 
ments should appear in an individual. All this will 
finally lead to a recognition of different types of effi- 
ciency, of different vocational and occupational apti- 
tudes and inclinations, so that there may be vocational 
discrimination, guidance, and training, each at the right 
time in a child's career. 

The special bent need not one-sidedly twist a child's 
education. It should furnish the point of vantage from 
which the entire field of learning may be entered, thus 
counterbalancing narrowing tendencies. But unless the 
child's main interest is taken as the starting-point, he 
will become hopelessly averse to study and all-around 
culture. 



442 THE EXCEPTIONAL CHILD 

An Experiment and Its Lesson. — It has often been 
pointed out that the traditional school courses in which 
the three R's play the principal parts have been fashioned 
for the purpose of preparing the pupils not for life so 
much as for the next higher educational step, the high 
school. This principle of considering the lower school 
essentially preparatory for the next higher is adhered to 
throughout the entire scholastic career of the child, from 
the primary school to the university. The fact that 
each step should be adjusted to the needs of the student 
at that stage of his development, irrespective of what 
may come after, is almost entirely lost sight of. 

To prove that the three R's are not even necessary in 
the preparation for high school — that the entire theory 
of "essentials" is wrong — and that we may consider the 
children's natural tendencies without risking eventually 
their "higher" education, Professor J. L. Meriam, of the 
University of Missouri, has for some years conducted an 
elementary school in the work of which "emphasis is 
given to the immediate needs of the pupils rather than 
to preparation for high school work." The following 
statements are quoted from Doctor Meriam's report in 
the Journal of Educational Psychology of June, 191 5: 

The pupils throughout the seven grades pursue four "studies": 

1. Observation of nature and industrial activities. 

2. Playing games of present interest. 

3. Handwork: making things of immediate usefulness. 

4. Enjoyment of stories, pictures, music. 

Reading, writing, arithmetic, and other such "common 
branches" are not taught as such at all. The content of such 
branches is used only as needed in one or more of the four studies 
constituting the curriculum of this school. 

This does not mean that pupils in this school do not learn to 
"read, write, and cipher." It does mean, however, that pro- 



SCHOOL PROBLEMS 443 

ficiency in these common school studies is made quite subordi- 
nate, as a purpose, to proficiency in "Observation," "Play," 
"Handwork," and "Enjoyment of Stories." Thus it might be 
rightly claimed that the work of this school should be measured, 
not in terms of school subjects, but in terms of the out-of-school 
activities of the pupils. But one of the cardinal principles of 
this school is: Preparation for later efficiency is acquired by 
being efficient in present activities. . . . Thus, while prepara- 
tion for high school work has been treated in this school as 
quite subordinate to another purpose, the assumption has been 
made that pupils trained in this school would prove equal to 
doing at least average work in the high school. 



The University Elementary School has been dealing 
with small classes, as might have been expected. After 
ten years of activity the total enrolment had reached 
347. Seventy-five have been graduated, but not all of 
these had all their work in this school. Sixty-six of 
those who graduated have done work in nine different 
secondary schools. An investigation into the standing 
of these students from a school where no formal work 
in the common branches is given, as compared with the 
other high school students, readily indicated that they 
ranked well right through the classes. Professor Meriam 
concludes: 

This is not a local problem. The formal subjects in the ele- 
mentary schools are adversely criticised and are undergoing a 
change. Yet parents and teachers are loath to give up the 
drill in the three R's on the ground that those subjects are pre- 
requisite for successful high school work. But the majority of 
elementary school pupils are destined not to enter the high 
school. These pupils should be taught the things that are of 
value to them, viz., the practical things of every-day life. If it 
can be shown that such studies prepare those who do go further 
in school as well as the study of the "common branches," a 



444 THE EXCEPTIONAL CHILD 

change in the curriculum of our elementary schools would be 
advisable. The investigation referred to above supports this 
theory. 

It is not uncommon that young people who have not 
had the advantage and opportunity of an early school 
training, will secure admission to high schools and even 
colleges, sometimes perhaps informally, but with the 
chance of improving their belated opportunity. They, 
who have had only "practical" training and experience 
in their childhood days, usually compare very favorably 
with their "learned" fellow pupils whose mastery of the 
three R's did not necessarily give them common sense. 

It may also be useful to refer here to a most interest- 
ing discovery made some years ago in Springfield, Mass. 
Examination papers, written by pupils of the public 
schools forty years or so before, were found which gave 
striking evidence of the "proficiency" of these pupils 
when almost the entire school work consisted of a con- 
centration upon the three R's. The papers did not 
show the superiority which some might have expected 
at all, but were rather mediocre in comparison with the 
work done in the modern schools of "frills and fancies." 
This mediocre work, however, did not prevent these 
pupils of a generation ago from succeeding in life. One 
of the poorest arithmetic papers,/, i., was written by a 
boy who later became a successful banker. The formal 
work in the "common branches," therefore, does not 
seem to have the value which has been attributed to it. 

Doctor Meriam's successful experiment shows that 
the author's contention in regard to differentiation of 
courses to meet individual needs has a basis in fact. By 
starting with the immediate interests and needs of the 
pupils, we may differentiate considerably without preju- 



SCHOOL PROBLEMS 445 

dicing scholastic progress when that is expected. And 
in case of changing interests and the springing up of 
unexpected variations, a new adaptation is perfectly 
possible. 

Another Experiment: The Play School. — Another in- 
teresting and instructive experiment was made in the 
summer of 1913 in the University of California, under 
the direction of C. W. Hetherington, by the institution 
of the "PlaySchool." 1 

Hetherington defines this experimental school as "an 
outdoor school and play centre combined, where the 
teacher's interest is centred in the children and their 
activities, not merely in subjects of study; where the 
educational efforts, including the moral and social, are 
put on a basis of practical living experience radiating 
into the whole environment; and where children are con- 
sidered both as free agents and as immature social crea- 
tures requiring aid, social control, and discipline. In- 
stead of teaching subjects, it organizes activities out of 
which subjects develop, as they have in racial history. 
The activities organized are the natural, more or less 
distinct phases of the child's complete life. The usual 
school subjects develop as phases of these activities." 

In the following is given a classification of activities 
as organized in Hetherington's Play School: 

I. Big Muscle Activities (Locomotion and Manipulation), 
including: 

(1) Spontaneous and General Locomotion; (2) Loco- 
motion with Toy Machines, Animals, etc.; (3) 
Spontaneous or Playful Gymnastics; (4) Games; 
(5) Dancing; (6) Aquatics. 

1 "The Demonstration Play School of 1913," University of California 
Press, Berkeley. 



446 THE EXCEPTIONAL CHILD 

II. Rhythmic and Musical Activities, including: 

(i) Rhythmic Movements, Dancing and Singing 
Games, "Eurhythmies"; (2) Tone Plays; (3) 
Singing; (4) Instrumental Activities. 

III. Manual Activities. 

(1) General Manipulation with Miscellaneous Objects, 
Toys, and Educational Materials; (2) Con- 
struction (all Materials — Tools); (3) Drawing; 
(4) Manual Dramatization (Sand and Floor 
Plays and Construction). 

IV. Environmental and Nature Activities, including: 

A. Excursions with Outing B. Experimentation. 
Arts, Adventure and 
Observational Games. 

(1) Observation on Physical 

Nature and Physical Nature 

Experiments. 

(2) Observation on Plant Na- 

ture and Plant (Garden) 

Experiments. 

(3) Observation on Animal Na- 

ture and Animal Experi- 
ments. 

(4) Observation on Social En- 

vironment, with Geograph- 
ical and Historical Rela- 
tionships (See Games and Social 

Activities). 
V. Linguistic Activities, including: 

(1) Spontaneous Vocalization and Expression. 

(2) Free Conversation and Discussion in all Activities. 

(3) Organized Intercommunication, i. e.: 

(a) Discussion, Oral Expression, Story-Telling, 

Debate. 

(b) Story-Hearing, Revealing Larger Relation- 

ships. 

(c) Reading to supplement Observations, to 

interpret and communicate. 



SCHOOL PROBLEMS 447 

(d) Written Expression, Communication: 
Composition, Spelling, Penmanship, 
Narrative, Story-Writing. 

(4) Mechanics of Reading and Writing. Games, etc. 

Preliminary 3c, 3d. 

(5) Mechanics of Number, Games, etc. Economic 

Dramatization. 

(6) Foreign Language. By Play and Conversation. 

VI. Dramatization (associated with other activities). 

(1) Imitative Dramatization; (2) Manual Dramatiza- 
tion; (3) Adaptation and Constructive Dra- 
matization; Plays; Pageants. 

Vll. Economic Activities, including: 

Production and Service of Economic Value. Accounts. 
(Economic Dramatization, see Numbers.) 

VIII. Social Activities, including: 

(1) General Contacts involved in the Social Aggrega- 

tion of the School and in the Several Activities. 
Friendships. 

(2) The Social Hour: 

(a) Music, general and by groups. 

(b) Dancing. 

(c) Story Hearing and Telling. 

(d) Dramatics by Groups. 

(e) Exhibits. 

(3) Social Functions, Celebrations, Pageants. 

(4) Group Club Activities. 

(5) Civic Service. 

The author had an opportunity of observing, during 
his visit to the University of California in 1913, the 
splendid success of this experimental work. It was 
altogether unique and bold, and illustrated forcibly how 
the education of children may be approached quite 
properly from very different angles. 

A Contrast. — Let us compare with the natural swing 
of work of this kind the formal exercises of our ordinary 



448 THE EXCEPTIONAL CHILD 

schools. The following few samples are taken at ran- 
dom from the State Examinations for the pupils in the 
highest elementary grade of an Eastern State: 

Geography. — Although England is comparatively small in 
area, she is a great world power. Give three reasons to account 
for this. 

Explain why free labor produced more farm products in the 
South than slave labor. 

Physiology. — What effect does alcohol have on the heart? 
On a man's character? 

Tell in a few words your opinion of patent medicines and their 
use. What does each contain that is harmful to the body? 

History. — (a) What is the purpose of a tariff? (b) State the 
attitude of each of the two great parties at the present time 
toward a tariff. 

(a) From what sources is the revenue derived to maintain 
the government of the United States? (b) Name five purposes 
for which it is expended. 

Compare the United States in 1800 with that of 1900 as to 
(a) population, (b) wealth, (c) area, (d) industries, (e) transpor- 
tation facilities. 

English. — Analyze the following sentence: "We sleep but the 
loom of life never stops; and the pattern which was weaving 
when the sun went down is weaving when it comes up to-mor- 
row." 

Write the following and underscore the illustrative words: 

(a) A simple sentence with a compound subject. 

(b) A sentence with a phrase used as a subject. 

(c) A sentence with a noun clause as the object. 

(d) A sentence with an adverbial clause. 

(c) A sentence with a verb in the passive voice. 

Arithmetic. — A family that rented a house for $55 a month 
concluded that it was less expensive to buy a house for $6,500. 
They paid annually $63.50 on account of taxes, $12 for water 
rent, $15 for insurance, and $75 for repairs. Before buying the 
house they received an income of 6 per cent on their money. 
How much money did they save or lose by buying the house? 



SCHOOL PROBLEMS 449 

These questions are typical. No doubt a number of 
children were perfectly ready to answer them correctly. 
Of course the rating was on a percentage basis. But 
the problem is this: 

Do questions of this kind in any way appeal to the 
natural interests and experiences of fourteen-year-old 
children ? 

Can children of that age have mature judgment 
enough to treat these subjects rationally and indepen- 
dently ? 

Will they carry into their lives after leaving school 
any appreciable benefit from handling these sub- 
jects ? 

Will work of this kind not give children the illusion 
that they are capable of handling big economic, histori- 
cal, and political problems with a minimum of wisdom, 
information, and scientific accuracy? 

If they can answer those questions at all, is it not be- 
cause of the mechanical memory work and book-lore to 
which they have been subjected throughout their school 
career ? 

By being forced to devote so much time and energy 
to unprofitable, superficial, and ill-adjusted work, have 
they not lost time, opportunity, and energy for the real 
work they ought to have done during this important 
formative period of their lives? 

Will they not leave school under these circumstances, 
ill prepared for what is before them, and with an unfor- 
tunate mental twist which will prevent them from dis- 
criminating between essentials and unessentials ? 

Is it not perfectly clear that consequently many of 
these graduates, not to speak of those who do not gradu- 
ate but leave school earlier or on account of non-gradu- 



450 THE EXCEPTIONAL CHILD 

ation, will be unable to adjust themselves to the prob- 
lems of life and become failures ? 

As a matter of fact, even where manual training and 
other life branches have been introduced, hardly any- 
where is proficiency in them credited to the pupils to 
offset weaknesses in the "common branches." This is 
the case even in high schools of the ordinary kind, where 
graduation is rarely affected by talent in art or con- 
structive work. Only in those secondary schools which 
bear a technical or "vocational" character is such con- 
sideration given. 

In some progressive school systems an innovation has 
been introduced which promises much for the future. 
There home-work credits are given, that is to say, the 
home activities of the pupils, their assistance in house- 
hold duties, in helping in the garden, on the farm, in 
the performance of chores of all kinds, are valued in 
terms of conduct, application, and proficiency, and the 
marks thus obtained are included in the school record. 1 
This revives the opportunities of earlier times, when 
children had a wealth of educational opportunity through 
the performance of these home duties. 

Two decades ago the author tried out, in the Ethical 
Culture School of New York City, the plan of issuing two 
different kinds of certificates to those who left at the close 
of the eight years' course. Those pupils who showed 
themselves capable of higher education, so-called, with 
whom, therefore, the completion of the elementary 
course was a stepping-stone to further work, a diploma 
was given stating this fact. To the others, who had 
completed the course without showing scholastic ten- 
dencies, even perhaps having failed in some of the "com- 

1 Cf. The School Bulletin, Syracuse, N. Y., November, 1915, p. 63^". 



SCHOOL PROBLEMS 451 

mon branches," but who had given evidence of mental 
maturity entitling them to graduation, a certificate was 
issued giving them full credit for their faithful and suc- 
cessful work, without branding them as scholastic fail- 
ures. They usually made good in their various callings. 
Either of the two certificates was accompanied by an 
elaborate statement of the details of the pupil's efficiency 
and personal endowments. 

The Problem of Methods. — Many are the mistakes in 
school methods, in the methods of presenting the various 
subjects of instruction. There is lack of depth and co- 
ordination, and often a most astounding lack of appre- 
ciation of fundamental facts on the part of the teachers. 
Even at this time, when so much attention has been 
given in normal schools to psychological principles in 
method, the most flagrant errors and abuses are ram- 
pant. This is evident in the most elementary beginnings 
of school work which is unfortunately left to be done by 
the least experienced novices in the profession who work 
for the minimum salary. Take, for instance, the teach- 
ing of the multiplication table. It is rarely appreciated 
that the sign X does not read "times" but stands for 
the operation of multiplying. It signifies ''multiplied 
by." To illustrate: When we have 6 + 2, it means that 
6 is the number to which "something is done" — another 
number, 2, is added to it. When we have 6 — 2, it 
again means that 6 is the number operated upon; some- 
thing is taken away from it. When 6 is divided by 2 
(6 : 2), the operation is that we want to find either the 
result of a division of the quantity into two equal parts, 
or the number of times 2 is contained in 6. But, again, 
6 is the fundamental number. Thus, when we have 
6 X 2, it implies that we wish to take 6 two times, not 



452 THE EXCEPTIONAL CHILD 

2 six times. But if we should read the example six times 
2, it would reverse the meaning of the operation. It 
should be read either 6 multiplied by 2, or 2 times 6. 
Unless this fact is borne carefully in mind, the young 
pupils will from the very start be confused in their 
mental conceptions and operations. But how many 
teachers do appreciate this fact? And this is but one 
of the multitude of fatal errors made in the primary 
grades. 

Professor Shiels, of the Catholic University in Wash- 
ington, D. C, has written a book on "The Making and 
Unmaking of the Dullard." And over fifty years ago 
R. B. Carter, an Englishman, wrote a brief essay on 
"The Artificial Production of Stupidity in Schools." 
Said he: 

An urchin may be able to say correctly that a word pointed 
out to him is an adverb or a pronoun, may proceed to give a 
definition of either, and examples of instances of occurrence, 
and may produce the impression that he understands all this, 
when the truth is that he has only learned to make certain 
noises in a particular order and is unable to say anything intel- 
ligible about the matter in language of his own. Or he may 
repeat the multiplication table, and even work it, saying that 
7 X 8 = 56, without knowing what 56 is, or what 7X8 means. 
He knows all about 7 or 8, not from schooling, but from the 
lessons of life, from having had 7 nuts or 8 marbles; but of 56, 
which is beyond his experience, he knows nothing. The nature 
of the mental operations of these children is perhaps as little 
known to the teacher ... as the mental operations of the 
inhabitants of Saturn. The adults distinctly understand a 
thing which they feel to be very easy, and do not know that any 
children can talk about it correctly without attaching an idea 
to their words. 

To how many of us does 56 mean anything concrete? 
Let us be modest and ask, To how many of us does as 



SCHOOL PROBLEMS 453 

small a number as 20 mean anything concrete? How 
many of us will recognize this small number accurately 
and promptly in the following irregular mass of dots ? 



As soon as we arrange this number of dots in some 
conventional form, we add them up easily: 



Examples of this kind can be multiplied. It is in part 
the great mass of methodical errors which vitiates the 
didactic process and causes pupils to become muddled 
in their mental operations, to live on words and symbols 
without ever touching reality, to fail in their school 
tasks, and finally to be launched from school into a 
world of actualities of which they have no understand- 
ing, and in the battle with whose stern demands they 
are defeated. 

Just because the beginnings of rational didactic work 
are the most important and fundamental, the first step 
in school work is to be most carefully considered. The 
author has devoted the next chapter to a consideration 
of methods adapted to the youngest children. Chapter 



454 THE EXCEPTIONAL CHILD 

XXII is a discussion of the kindergarten period in lay- 
ing the foundation of sane mentality by recognizing 
individual differences. A discussion of the Montessori 
method is inserted. This insertion has been made be- 
cause so many educators and lay people have hailed this 
new movement as the one great liberator of the child 
from the fetters of irrational school training. It is well, 
therefore, that in a discussion of the problem of school 
adjustment to the individual child, for the purpose of 
forestalling his failure in life, some attention should be 
given to the claim. 



CHAPTER XXII 
THE KINDERGARTEN PERIOD 

A New Gospel of Freedom. — When the kindergarten 
was first introduced in this country, it was justly hailed 
with enthusiasm as a new gospel of freedom from scho- 
lastic narrowness and pedantry. It gave a new outlook 
upon the possibilities of child development. It took 
advantage of those valuable formative years which had 
been neglected by the traditional school where education 
was held to be synonymous with book-learning. It led 
the educator back to some realities in child life. And 
it recognized the symbolic stage in the development of 
the child mind. 

It has, however, not altogether justified, in its practi- 
cal development, the expectations of its advocates. Its 
symbolism has run wild; its system has degenerated in 
many places into a rigid formalism; the externals have 
pushed the underlying principles into the background, 
and the kindergarten has suffered from the same diffi- 
culty which has been the curse of primary education 
throughout the land, namely, that the youngest tyros 
in education were considered good enough to teach the 
youngest children, those precious, delicate minds and 
souls to whom the wonderland of the world is just un- 
folding itself. 

Genetic Psychology vs. Stereotyped Forms. — It is not 
the purpose of this book to enter into a discussion of 
these criticisms. But two great mistakes which have been 

455 



456 THE EXCEPTIONAL CHILD 

made must be discussed here: The one is that in the 
general kindergarten practice the original Frobel Gifts 
and Occupations, Games and Songs have been adhered 
to without modification, in a stereotyped form, and with 
the exclusion of everything that might have enriched 
and broadened the life of the kindergarten children. 
Thus, there was a relative paucity and one-sidedness of 
educational material which left many a child of that age 
unprovided for and unappealed to. For the newer ap- 
preciation of genetic psychology has taught us that the 
child is a much more complex being than was known at 
the time of Frobel, and that the laws of the develop- 
ment of the individual cannot be understood without a 
knowledge of race psychology and biology. 

Uniform Standards. — Again, the rigidity of general 
practice makes itself felt in the tendency toward uni- 
formity. Group work is the rule; individual work the 
exception. All children in the same group are supposed 
to do the same thing practically in the same way at the 
same time. Individual differences in execution which, 
of course, cannot be avoided, are as far as possible dis- 
couraged so that a uniform standard of perfection may 
be attained. 

The children march and sing at the same time, they 
dance and play in a prescribed and imitative fashion 
when the programme requires it; they weave and model 
and draw and lay sticks and build at the same time, in 
a formal way and following conventional, traditional 
patterns. 

Penalty of Success. — It has been, in a measure, a 
misfortune for the kindergarten that it has succeeded 
so well in this country. In its own native home it has 
never been fully recognized in the public school system; 



THE KINDERGARTEN PERIOD 457 

and private initiative, adapting itself to local and special 
needs, kept the kindergarten idea freer from formalism 
than it was possible here. As soon as the kindergarten 
became a feature of public school education, in the 
American system, it partook of the faults characteristic 
of that system. It ceased to be a kindergarten and be- 
came a classroom arrangement. It imprisoned the chil- 
dren indoors and became a matter of chairs and tables, 
and order and discipline, and quiet and co-ordination. 
However, the young child is repeating, in his life in- 
stincts, his games, his experiments with the world about 
him, the experience of early race history. He wants to 
play on the floor, not to sit orderly, for any length of 
time, on a chair; he wants to play in a sand-heap, not 
on a sand- table; he wants to be dirty, not neat; he 
wants to play with water, and wade, and throw, and 
climb, and drop things, and play hide-and-seek, and use 
a stick, and do all sorts of primitive things. The child 
who easily conforms to the routine of an orderly kin- 
dergarten is either abnormal or subdued. 

The Young Child Is Individualistic. — Again, the young 
child is not naturally a social being. He is individual- 
istic, just as his remote ancestors were who saw a com- 
petitor in every other individual. True, this indepen- 
dence and asocial condition must be converted into a 
realization of the social conscience. But this is a 
growth which cannot be forced, or else it will be an 
artificial thing, and the child so constricted will harbor 
an everlasting resentment against a social order which 
curtails his freedom. No wonder that we have so little 
community spirit among our grown-up population. The 
time comes naturally when the child, seeking companion- 
ship for the projection of his own personality into other 



458 THE EXCEPTIONAL CHILD 

lives, and enlarging his own personality by making 
others a part of his own emotional and mental being, 
will socialize himself. Then the rights and privileges 
of community life, as well as the duties and functions 
involved in it, will enter into his consciousness. 

Montessori Influence. — It is here that the so-called 
Montessori methods have hit the kindergarten hard. 
These methods and suggestions are by no means origi- 
nal, having been used for a long time in a progressive 
reconstruction of school and kindergarten systems. 
They have characterized the work for the difficult and 
abnormal child in particular, and had been formulated 
long before we had heard of Montessori. It is, however, 
interesting to note how the American public, as soon as 
a foreign voice was raised in iconoclastic enthusiasm, 
immediately clamored for the recognition of principles 
which it had so long considered with distrust. Now, all 
of a sudden, teachers discover that it is really possible 
to have a group of children under individual freedom 
much greater than it had been thought feasible. In the 
light of these principles the teacher is first of all an 
observer. She studies the situation and acts accordingly; 
she does not approach the child with a preconceived idea 
of system. She realizes that obedience is a sacrifice 
of self on the part of the child; a sacrifice that will be 
made more readily when the child — not knows, for that 
is impossible at that stage — but feels the necessity for 
it, through the confidence which his educational leader 
and his comrades inspire in him. This is certainly the 
manner in which a normally vigorous child is educated 
in the home. Force and punishment, fear, and even 
an artificially stimulated desire to please, will never de- 
velop a child's best, innermost faculties. He may be- 



THE KINDERGARTEN PERIOD 459 

come a conformer, a pattern, a hypocrite, a coward, a 
prig, an "average" child, but never a character. 

Racial Differences. — The Montessori movement sug- 
gests another thought. It represents an effort at educa- 
tional reform largely adapted to the children of Italy. 
Some of the singular omissions observable in the sys- 
tem, some of its surprising features, yes, even the very 
extremes to which it goes in the matter of freedom, 
must have their cause and origin in the conditions under 
which it was developed. These local conditions are 
racial and historical. For this very reason it cannot be 
merely copied in America. These conditions have been 
discussed elsewhere in this book; suffice it to say that 
here is a field of fruitful study and discovery. But what 
we may learn from these facts is this: that in applying 
any educational system or method we must consider 
racial differences. There is a difference in racial atmos- 
phere and attitude, life habits and emotional response, 
even in cultural development. What appeals to one 
race will not appeal to another. In our country, with 
its mixture of raw material cast upon our shores from 
different countries, it is absurd to think that kindergar- 
ten practice can be the same in the Italian sections as 
in the ghettos, in the Polish districts as in those inhab- 
ited by families of German or American lineage. And 
where, in any individual kindergarten, there is a con- 
glomeration of racial types, the work will have to be 
carefully differentiated to meet the needs of native in- 
stincts and ideals. And even within the racial groups 
there are different civilization levels (cf. Chapter III). 
For the children of these various elements the kinder- 
garten period of development means many different 
things. 



460 THE EXCEPTIONAL CHILD 

Individual Types of Mind. — It is almost superfluous 
to add that further adjustments of the daily routine 
must be made to suit the needs of individual types of 
mind. Do not say that the young child does not pre- 
sent such a variety of problems. Quite the contrary: 
It is essential to make distinctions at the early age, so 
as to start the child right on his career. It must be 
admitted that the finer individual differences, such as 
represent an accumulation of family traits, imitations 
of environmental conditions, and special endowments 
and preferences, manifest themselves fully only at the 
period of adolescence. Yet even in the baby difference 
of type is clearly recognizable. 

Differences in Growth-Rate. — There is, first, the dif- 
ference in physical and mental growth-rate. Not all chil- 
dren of 3 or 4 can even wear garments of the regulation 
size, or react upon stimuli in a uniform manner. Their 
sense-perceptions and reactions will show wide differ- 
ences; their motor co-ordination, their balance, their imi- 
tative and constructive ability will vary within wide 
limits. Their endurance, their concentration, their abil- 
ity to learn from errors will show a multitude of differ- 
ences. They will progress with a very great diversity 
of speed. Some will still need the large gifts and to 
work in their occupations on a large scale, when others 
will have proceeded to be able to cope with rather minute 
adjustments. Some will still be satisfied with the sym- 
bol when others will want realities. Age is a very rela- 
tive thing. 

Mental Attitudes and Aptitudes. — Further, there are 
distinct differences in mental attitude and aptitude. 
Some children are born individualists, born leaders; 
others are naturally conformists and want to be led. 



THE KINDERGARTEN PERIOD 461 

There is the child who is afraid of nothing; and the 
other who shrinks from publicity and competition. 
There is the one who is always original and inventive, 
and who hates to merely imitate; others have no spark 
of originality and depend absolutely upon models and 
patterns. Should we not consider these differences 
among many others? Surely it cannot be said that it 
is one of the first duties of the kindergartner to curb 
the forward child, to check the impulse of leadership, to 
mould the heretic thought and non-conformist method 
into the form of conventionality. The history of the 
race is so full of bloody struggles against orthodoxy of 
all kinds that we should guard against the stifling of 
souls in the beginning of their growth. Not oppression, 
but wise guidance on the basis of a real understanding 
and appreciation of underlying motives and conditions 
is what is needed. It is only too often the bright child, 
the child of initiative, that is made the victim of the 
levelling efforts even at this early period, so that his 
career is hazarded from the first. So few of us have 
the faculty or the patience to enter into the intentions 
of little children. Their actions are often gravely mis- 
understood, their motives unappreciated, their minds 
and morals undervalued, their emotions misrepresented. 
A gulf will then open between the teacher, or parent, and 
this budding soul, a gulf difficult of bridging; and the 
young heart will shut itself in and the young mind will 
be warped. 

Conventional Symbolism. — To illustrate, reference 
may be made to a very common practice. The kinder- 
garten teacher will draw houses, tables, cats, and other 
things on the blackboard, or show these forms in the 
way of stick-laying; or develop sequences with the build- 



462 THE EXCEPTIONAL CHILD 

ing gifts, illustrating steps, bridges, and other struc- 
tures; or punch holes in sewing cards for the sewing out 
of conventional and life forms, etc. ; and the children are 
expected to imitate these things in the regulation way. 
This presupposes that they see the things represented in 
the same symbolical form the teacher sees them, and 
which is intended to contain all the essential features of 
the objects thus delineated. But a study of the sponta- 
neous drawings and structures of children shows that 
this is a mistake. Children do not see things in the 
regulation way. To them features seem essential that 
are quite different from those the teacher thinks should 
be shown in the reproduction. 

The blackboard forms of houses, cats, etc., are noth- 
ing but pictographs, picture-writings, hieroglyphics, as 
it were, symbols of the real things, and the child uses 
them as such. In the ordinary practice, whenever he 
is asked to draw, or lay with sticks, or build with blocks, 
or what-not, a certain object first presented in the form 
described, he will always reproduce the original symbol 
without any freedom of deviation, or any attempt to 
express what is really in his mind. Thus, a conventional 
method is introduced which counteracts the natural in- 
stinct of the child to represent things in his own way. 
The ordinary exercises perpetuate this conventionaliza- 
tion. Individual attitudes and visions are entirely lost 
sight of, and much opportunity is lost of studying and 
understanding what is really in the child's mind, or 
where his aptitude lies. 

Imitation is said to be one of the fundamental in- 
stincts of the child at early stages. True enough; but 
imitation rightly understood. As said before, there are 
children who can do little more than imitate; but they 



THE KINDERGARTEN PERIOD 463 

must not set the pace for all. As soon as the teacher 
leads the child into stereotyped form, she is on the 
wrong track. She must always first appeal to the child's 
own method, and merely assist him in expressing himself. 
In this connection the author is, as he often is, reminded 
of the paradoxical saying of the late Doctor Harris: 
"Of course, the teacher must be an example; but she 
must take care that no one follows it." In other 
words, while she should be an inspiration to the child 
to find the right path, she must never be a pattern 
after which he moulds his own individuality. 

Illustrative Cases. — It may be of interest to quote 
here the contrasting types of two boys from a report 
of a kindergartner at "Herbart Hall" (Cases 74 and 
75). A is older than M, and an entirely different 
type of mind, although both were very backward when 
they came and really beyond kindergarten age, so- 
called. 

A showed in his Gift work a preference for small material, 
dull colors (always chose the brown tablets instead of the red, 
blue, and yellow), and accurate details in construction. His 
natural diffidence called for an encouraging method. I used at 
first the free play, then combined it with imitation and sugges- 
tion. Toward the end of the year he had acquired confidence 
in his own powers, and, in response to any given suggestion, 
would bravely choose his own material to carry out an idea. 

In many cases the suggestions came from his little school- 
fellow, M. This child has a powerful imagination and at the 
same time a marked tendency to utilize the things he can get 
hold of. Once, while building with the Sixth Gift (large size) 
he found that his train was so tall that it could not pass under 
a four-block high bridge. He then brought two loads of boxes 
(8) from the cupboard and made a fine bridge. When A saw 
what M did, he took the cover of a cardboard box and improved 
his house. 



464 THE EXCEPTIONAL CHILD 

As a rule A would spend the full Gift period in making and 
perfecting one construction, while M would build ten different 
things, in a careless, rapid way. A's perseverance in his work 
is quite remarkable. One day he tried to build a castle with 
the tablets of the Seventh Gift. As the task seemed too hard, 
he tried to make a tunnel. When told that the tablets were 
not intended for that purpose he begged to be allowed to try. 
And although he spent thirty minutes in trying (the tunnel 
came down twelve times) he finally succeeded in showing me a 
smooth, carefully finished tunnel about ten inches long. 

Examples might be multiplied. 

The Kindergarten Principle. — The author wishes to 
have it understood that he believes in the possibilities 
of a real kindergarten. All the Gifts and Occupations, 
all the Games and Songs, and all the traditions have 
their legitimate place. But the kindergarten is more 
than all that. It is a principle, and around that princi- 
ple we may assemble a multitude of means and methods 
among which we may discriminate for the sake of reach- 
ing the individual child. 

The Montessori Cult. — Inasmuch as a surprising 
number of lay people, parents, and even teachers in this 
country have hailed the Dottoressa Montessori as the 
new savior of the child, and her doctrines as a veritable 
gospel of child conservation, it seems necessary to say 
here at least a few words in regard to the "new method." 

Of course, it is not a new method at all. It contains 
no new principles or inventions. Frobel was a forerun- 
ner of modern psychology, the creator of a new thought 
(no matter how imperfect some of his methods were), a 
seer, and his work will have to be recognized as having 
broken new paths even after his Gifts and Occupations 
are long forgotten. Montessori is mainly a compiler 
and digester. 



THE KINDERGARTEN PERIOD 465 

The Principle of Freedom. — Both Frobel and Mon- 
tessori appeal to the same period in child life, the age of 
3 to 6. Frobel gave many of his suggestions for use in 
home education, and his "Mutter- und Koselieder" 
(" Mother-Play Songs") will be immortal. Montessori 
seems to lay less stress on the home element, perhaps 
under the influence of Italian conditions. But just in 
this period of a child's life, the principle of freedom is 
of the greatest importance. It has been claimed that 
this freedom has found its first thorough realization in 
the "case dei bambini." Montessori rejects stationary 
desks and chairs and says: 

The lesson must be presented in such a manner that the per- 
sonality of the teacher shall disappear. She must be warned 
of two things: First, not to insist by repeating the lesson; and 
second, not to make the child feel that he has made a mistake. 

These demands are psychologically valuable, but can- 
not be enforced too rigorously. Besides, the freedom 
which she demands is rather illusory, as she has very 
fixed rules and restrictions, and says: 



The liberty of the child should have as its limit the collective 
interest ; as its form, what we universally consider good breed- 
ing. We must, therefore, check in the child whatever offends 
or annoys others, or whatever tends toward rough or ill-bred 
acts. But all the rest — every manifestation having a useful 
scope— whatever it be, and under whatever form it expresses 
itself, must not only be permitted, but must be observed by 
the teacher. Here lies the essential point: from her scientific 
preparation the teacher must bring not only the capacity but 
the desire to observe natural phenomena. In our system she 
must become a passive, much more than an active influence, and 
her passivity shall be composed of anxious scientific curiosity, 



466 THE EXCEPTIONAL CHILD 

and of absolute respect for the phenomenon which she wishes to 
observe. The teacher must understand and feel her position of 
observer; the activity must lie in the phenomenon. 

Little objection, if any, can be made against this 
conception. It has been preached by progressive edu- 
cators for many years past. Frobel knew no stationary 
desks or chairs; and movable seats and tables have been 
introduced in many leading schools long ago. German 
pedagogy has always recognized the child as the real 
centre of instruction, and has taught the gospel of "edu- 
cation in freedom." Pestalozzi, a century before, 
preached the same sermon over and over again. 

Wise Teachers Required. — Education in freedom and 
for freedom is, however, a very difficult task, and re- 
quires well-trained, experienced, and wise teachers. The 
want of these has wrecked many a kindergarten; it will 
be the danger-point for the "Montessori school." 

Objectivity of Instruction. — It is hardly necessary to 
emphasize that Montessori 's suggestions on behalf of 
objectivity of instruction and of proper sense training are 
restatements of old pedagogical teachings and offer lit- 
tle that is new, unless it were the introduction of such 
terms as "thermic," "baric," and " stereognostic " 
senses. This does not mean that we may not feel in- 
debted to her for several skilfully planned pieces of 
didactic apparatus. Some of them are taken from the 
methods of teaching the feeble-minded from which the 
Dottoressa originally started, and which have been in 
use for many years. One of these is the form board, 
first developed by Seguin when he was superintendent 
of the institution in Waverley, Mass., together with 
other similar material suggested and used by him. Her 
advice to use with normal children methods which 



THE KINDERGARTEN PERIOD 467 

were originally intended for the instruction of the men- 
tally deficient, valuable as it is, is again nothing new. 
In fact, there is no fundamental difference between 
methods used for the feeble-minded and those employed 
in regular schools. The principles are the same, only 
that in teaching the retarded or even the defective child 
we must lay special stress upon the first steps and pro- 
ceed much more slowly and cautiously. To leave out 
these first and fundamental steps in the education of 
the so-called normal child, is indeed a great mistake, 
which has its cause in a misappreciation of the develop- 
mental stages of the child's mind. In fact, this misap- 
preciation and the consequent neglect of the first steps 
are the chief causes of many derailments and " excep- 
tional" developments. 

Montessori lays much stress upon systematic sense 
training. She has definite exercises, also, for the tem- 
perature-sense, the muscle-sense, and the perception of 
weight, etc., which have been much neglected by teach- 
ers. The child's diet and physical training are also 
given much attention. To her the generally accepted 
idea of gymnastics seems inadequate. She recommends 
exercises in walking and running, breathing, talking and 
articulation, dressing and undressing, buttoning and 
lacing, in carrying and handling things like cubes, balls, 
etc. She emphasizes walking and running, as there are 
very specific morphological changes going on in the 
body of children of that age which are stimulated by 
these exercises. But she eliminates rhythm from march- 
ing and insists mainly upon correct posture and gait. 
Group work does not appeal to her; she wants to indi- 
vidualize almost exclusively. This is in contrast to her 
demand that the child must be prepared for the forms 



468 THE EXCEPTIONAL CHILD 

of social life. By way of games and occupations she 
recommends Frobel's geometric gifts, balls, hoops, kites, 
bean-bags, also running games like puss-in-the-corner, 
catching, etc. — most of which can certainly not be 
played without group work. 

Facts vs. Imagination. — All this contains much that is 
good and useful. But her system has a fatal defect in 
principle which places it in sharp contrast to Frobel's. 
She wishes nothing taught but facts. Children must 
learn the "truth" and nothing but the truth. In other 
words, she confines the work to cold, dry observations, 
and in the explanation and expression of these she de- 
mands the fewest words, the briefest sentences possible. 
Her motto is: nothing superfluous. Imagination, the 
play of fancy, anything symbolic — she wishes to be put 
under ban in the education of these little ones. She 
rejects the dramatic games of the kindergarten, like 
those of the carpenter and the shoemaker, and re- 
places them by real sawing and hammering. The 
fanciful stories of the kindergarten are condemned as 
silly. 

Culture Epochs. — These extreme views give evidence 
of her misunderstanding and misinterpretation of a 
child's early development. This is the more surprising 
as she seems to have some conception of the culture- 
epoch theory which has been explained elsewhere in 
this book (pp. 41 jf). Says she: " The child follows the 
natural way of development of the human race. In short, 
such education makes the education of the individual 
harmonize with that of humanity. Man passes from 
the natural to the artificial state through agriculture. 
When he discovered the secret of intensifying the pro- 
duction of the soil, he obtained the reward of civiliza- 



THE KINDERGARTEN PERIOD 469 

tion. The same path must be traversed by the child 
who is destined to become a civilized man." 

In this way she endeavors to justify the gardening 
occupations of the young child, being engrossed in the 
material externals and forgetting the conditions of psy- 
chic evolution. The beginning of culture in the human 
race is a period of mythos, of nature-worship, of per- 
sonification of the natural forces, of fetichism, of sym- 
bolism. The young child, likewise, lives in a symbolic 
world of his own, fairy-tale like, and does symbolic 
things, plays in a world of fancy out of which the real 
must evolve as the truly ideal. Even the child of i and 
2 does many unreal things, " makes believe," feeds his 
doll or hobby-horse from an empty plate, plays he is 
somebody else, etc. The entire psychic complexus of 
primitive man is mirrored in the young child. Frobel, 
in his games, has recognized the dramatic instinct of 
the child and gives ample space to the child's world of 
fancy. That Montessori fails to do this is a fundamen- 
tal defect of her system. She goes to the other extreme 
— while mistaken kindergarten methods, as was shown 
before, have overemphasized the symbolic element. 

Premature Scholastics. — Her "practically" inclined 
mind also induced her to instruct her pupils as early as 
possible in scholastic things proper, and to suggest 
methods which may lead to a rapid mastery of reading, 
writing, and arithmetic. Modern pedagogy is suspicious 
toward the early introduction of these arts. One is 
justified in claiming that it is contrary to the natural 
development of the youthful mind and cannot be sup- 
ported by the facts of physiological psychology. The 
young child must master a wealth of impressions and 
experiences before he needs to approach formal instruc- 



470 THE EXCEPTIONAL CHILD 

tion. Of course, children vary in their type and in the 
rate of their bodily and mental growth, and some may 
be able to bear an early taxing with "learning" more 
easily than others. And it has often enough been dem- 
onstrated that it is quite feasible to teach otherwise per- 
fectly normal children the arts of reading, writing, and 
figuring at an early age, by the employment of suitable 
methods and by special emphasis being laid upon this 
teaching. This has been done in many cases. Some 
of them have been discussed in Chapter VII. But these 
early readers frequently grow up to be rather mediocre 
adults, and it is hardly intelligible what purpose can be 
accomplished by driving methods which rob the children 
of most of what is necessary and natural at the early 
age. It is certainly not educational in the broad sense 
to do these things so that the children may be early 
bread-winners. They are apt to lose in the long run. 

Methodical Devices. — Montessori's methods in teach- 
ing reading, writing, and arithmetic have been used in 
more or less modified form for years. Her form boards, 
her number rods (cf., for instance, the "graduated 
wooden rods" in Shuttleworth and Potts's book on 
"Mentally Deficient Children," p. 153), her Big Stair, 
and other devices which have aroused so much admira- 
tion, have been employed before, although sometimes 
on a smaller scale. To have them in large size is com- 
mendable and in harmony with the newer kindergarten 
practice of having large-size gifts. 

Her reading method in which she lets children read 
words and sentences mechanically without understand- 
ing their meaning, cannot be seriously defended. 

Montessori is a clever practical teacher, of a pleasant 
and magnetic personality. She has a solid foundation 



THE KINDERGARTEN PERIOD 471 

of physiologic and anthropologic information and is well 
schooled psychologically and medically. She has read 
much and has the knack to compile and work out didac- 
tical ideas and material which have come down to her. 
She is essentially constructive and an intelligent or- 
ganizer. This has given her occasion to do a valuable 
piece of work which should and will be recognized. 
Her so-called system is defective because it is one-sided 
and incomplete. But in conjunction with other pro- 
gressive methods it can be utilized in formulating proper 
methods of teaching and training young children. It is 
for this reason that space has been given it in this book 
which is devoted to a brief discussion of provisions and 
methods which may prevent, if possible, educational 
failures due to faulty methods of early education. 

An Ideal Plan for the Kindergarten Period. — A kin- 
dergarten should have the wide scope of a well-regulated 
home in which each child may live his own life and 
share the life of his fellows. There should be presiding 
over it a motherly spirit of large sympathies and of fine 
discriminative power, with large resources as to self- 
adjustments to ever-changing situations. There must 
be the atmosphere of freedom and encouragement. 
There must be readiness of a true interpretation of all 
manifestations of the budding infantile minds. There 
must be open-air work, in a garden, in a yard, with 
sand-piles, flower-beds, climbing-ladders, swings, and 
puddles. The room of the kindergarten must be a 
paradise of toys and activities. Add the work-bench 
and the multitude of really educational toys and oc- 
cupations which are so abundant nowadays, to the 
traditional gifts of the kindergarten. Break up the 
monotony and the routine of the orthodox programme, 



472 THE EXCEPTIONAL CHILD 

and introduce the child into a world of real life. There 
are numberless songs and games that can be safely 
adopted into the system. Let the children express their 
own feelings in free rhythm, in dance and song. Do not 
tarry too long over the songs of the shoemaker, black- 
smith, and carpenter, but take the children to the 
workshops to see the men at work. Take them on ex- 
cursions to the country instead of merely singing and 
talking about the farmer and about sowing and reaping 
and thrashing. Let them have miniature garden-farms 
and shops of their own, with real tools and spades and 
wheelbarrows and work that will give their growing 
bodies exercise such as mere calisthenics will never pro- 
vide. There should be more virility in the kindergarten, 
not merely girlish notions of butterflies and dandelions 
and chickadees. Do not for a moment forget that even 
little boys are real boys after all. Then there will soon 
be a wonderful activity and bustle, and the individual 
aptitudes will manifest themselves for you to observe 
and study and make use of. Use — not for the indi- 
vidual child alone, but for the child-community which 
will profit by this sharing. And the sharing will react 
in a socializing way upon the individual. Break up the 
lockstep in the kindergarten and set the example for 
our elementary and high schools so that they, also, may 
set the child free and give the different types oppor- 
tunity to grow unfettered, but discreetly guided. 

After all, we can do our best only when we can act in 
our own way, and be ourselves. Then we shall also 
appreciate other selves and enter into genuine altruistic 
relations. A community built up by enfranchised indi- 
viduals who care neither for convention, nor tradition, 
nor precedent, nor fashion; whose judgment is not 



THE KINDERGARTEN PERIOD 473 

affected by fear or false ambition; who strive for the 
best that is in them and feel sure of an appreciation of 
their motives — will be the strongest on earth. The 
poet's word is applicable to the kindergarten child as 
it is to the grown-ups: 

"To thine own self be true, 
And it must follow, as the night the day, 
Thou canst not then be false to any man." 



CHAPTER XXIII 

GENERAL PROVISIONS FOR VARIATIONS FROM TYPE 
AND FOR DEVIATIONS FROM THE NORMAL 

In the previous chapters of this part two particular 
problems have been discussed. The one was how to 
secure, as far as it is humanly possible, a clean and nor- 
mal birth to a child so as to prevent conditions which 
would lead to failure and derailment from hereditary 
and congenital causes. The other was a consideration 
of an educational policy in school and home, and of such 
social and environmental conditions as would grant to 
normal and potentially normal children opportunities for 
complete individual development, giving full swing to 
individual variations of type. 

In this and the following chapters we shall approach 
the problem of those children who represent difficulties, 
physical, mental, or moral. Having discussed previously 
the "typical" and " pseudoatypical " children (cf. classi- 
fication), we are now dealing first with the truly "atypi- 
cal" child, and then with those children who belong to 
the subnormal and abnormal groups. The "atypical" 
children represent variations from type ; the others are 
deviations from the normal. 

Much has already been said in the first two parts of 
this book of the methods required to deal with these 
children adequately and justly. So these considerations 
will be more in the nature of a concise statement and 
summary. 

474 



VARIATIONS AND DEVIATIONS 475 

Proper Diagnosis the First Requisite. — It is plain that 
the first requirement for dealing with genuinely handi- 
capped children is to make a thorough diagnosis of each 
case. 

In order to safeguard all children as far as possible, 
inasmuch as mere observation in ordinary class work 
is a slow and inaccurate process, every child entering 
school should be examined first of all in the educational 
clinic described in the second part of this book. This 
will give the opportunity of classifying the children as 
to type, physical and mental endowments or weaknesses, 
etc. Child history items, statements about home condi- 
tions, reports of family physicians, etc., should be kept 
on record for reference. The department of medical in- 
spection should be expected to co-operate promptly with 
the educational clinic for the purpose of establishing the 
physical status of the child. This will help to deter- 
mine a child's powers of endurance and resistance, the 
keenness or defects of his sense reactions (thus regulating 
the problems of seating, light, etc., for each pupil), and 
all those other conditions which enter into a valuation 
of the child's physiological and biological characteristics 
and needs. 

The medical clinic should have departments for exami- 
nations and measurements of anatomical and functional 
conditions, for the testing of vision, hearing, and other 
senses; for ear and throat examinations, dental work, etc. 
It should be under the direction of a competent physi- 
cian with a sufficient staff of trained assistants and 
nurses. The chief inspector should be in constant touch 
with the chief of the educational clinic, and the entire 
department is best under the management and control 
of the educational authorities. 



476 THE EXCEPTIONAL CHILD 

Objects of Medical Inspection. — The objects of medi- 
cal inspection may be summed up as follows: 

A. Prevention of development of disease or of physical de- 
rangement in children. 

B. Recognition of existing physical difficulties and of their 
manifold complications. 

C. Removal of ailments, and co-operation in overcoming ed- 
ucational, social, and other handicaps resulting therefrom. 

A. Prevention of Development of Disease or of Physical Derange- 

ment in Children. 

This requires: 

i. Regular and thoroughgoing examinations and physical mea- 
surements to immediately offset incipient unhealthy 
development of any description. 

2. Guarding the health of the school community by prompt 

measures when contagious and infectious diseases 
appear. 

3. Enforcing the rules of proper school hygiene, and encourag- 

ing the hygienic care of the individual pupil and his 
home. 

4. Instruction given to teachers and school officers to recognize 

danger-signals promptly. 

B. Recognition of Existing Physical Difficulties and of Their 

Manifold Complications. 
Here we must distinguish: 

1. The recognition of physical difficulties as such: 

Defects in the special senses; diseases of the ear, eye, 
nose, throat, teeth; disturbances of digestion, cir- 
culation, assimilation; skin diseases; tuberculosis; 
venereal infection; bad sexual habits, and malfor- 
mations of the sexual organs; neuropathic and 
psychopathic conditions, etc. 

2. The relation of these physical difficulties to the mental life 

of the child. 

3. The relation of these conditions to the moral life of the child. 

4. Recognition of the effect these conditions (acute or chronic 

in character) may have upon the vocational career of the 
child and upon his usefulness as an independent citizen. 



VARIATIONS AND DEVIATIONS 477 

C. Removal of Ailments, and Co-operation in Overcoming Edu- 
cational, Social, and Other Handicaps Resulting Therefrom. 
Under this head these points have to be considered: 
i. A mere removal of some physical ailment is not a complete 
remedy, nor is it always a simple or rapid process; 
educational methods must be employed after the 
medical relief, or even along with it, to accomplish res- 
toration to normal functioning. 

2. Thus, diagnosis and treatment require the co-operation of 

the educator and the psychologist with the physician, 
inasmuch as the physiological aspect of a case is in- 
timately bound up with psychological and emotional 
elements, and with facts of educational and social im- 
port. 

3. Physical difficulty, combined with mental and moral varia- 

tion, is the keynote of exceptional development in 
children; hence, in their cases, medical and educational 
co-operation is particularly indicated. 

4. Just as physical conditions affect the mental and moral 

states, the latter have their specific influence upon 
physical developments as such. In other words, emo- 
tional elements, volitional control, psychic states, 
imaginings, etc., react upon the body in general and 
influence functional reactions. Hence, again, the need 
of an all-sided co-operation. 

If all this is to be accomplished by medical inspection, 
it must be developed to a high state of efficiency. At 
present we have makeshift arrangements in most places. 
In lieu of busy practitioners who are employed on a 
meagre salary to do some ill-organized inspection work 
in the schools, we should have a corps of specially trained 
and well-paid physicians with whom this work is a life- 
calling. We need them for the schools at least as much 
as we need them for hospitals and asylums. If we com- 
pare the number of trained men and women employed 
in the asylums for the insane with the number employed 



478 THE EXCEPTIONAL CHILD 

in the schools, we shall realize the inadequacy of the 
school provisions. 

School nurses and social visitors will complete the work 
by co-operating with the homes of the pupils whenever 
necessary. An effective following-up system should be 
devised so that each child may have the full benefit of 
these provisions. 

Repeated Examinations. — Children change, often 
quite rapidly, in accordance with the laws of growth, 
which work with each individual in compliance with all 
the factors which differentiated him from the others, so 
that there is an endless variety of combinations. In 
this manner the unfolding of an individual psyche is 
full of surprises. To catch the budding instincts and 
capacities, to keep on the track of every new change, it 
is necessary to repeat the examinations of body and 
mind at regular intervals. 

In this wise we may forestall derailments, or if we 
cannot turn the course of an undesirable develop- 
ment, we may at least discover its origin and follow 
it up. 

At certain junctures a child should be under closer 
observation than ordinarily. For school adjustment, 
for the sake of his moral evolution, or even for his physi- 
cal development, he will then need greater care and 
more minute scrutiny. Co-operation with the home 
will always be indicated. But each school system should 
organize observation classes, perhaps even observation 
schools, for scholastic and disciplinary purposes, without, 
of course, attaching any penal, stigmatizing, or com- 
promising features to the transfer into classes or 
schools of this kind. It may be well to have, also, in 
addition to the observation day school, an observation 



VARIATIONS AND DEVIATIONS 479 

parental school, where the children can be observed and 
studied in their habits of life and conduct. 

A System of Clinics. — As has been shown in the chap- 
ter treating of the meaning of an educational clinic, 
these clinics, together with the medical clinics, may be 
considered as feeders for a number of special clinics in 
which much expert work shall have to be done, to sup- 
plement the work of the clinics of the first order. There 
will have to be pathological laboratories at the service of 
the school clinics, for the making of blood tests, sputum 
tests, examination of faeces, urine, and cultures of all 
kinds. There should be psychological clinics for the 
study of cases which require more elaborate and intimate 
psychological examinations. These psychological clin- 
ics will also be helpful through developing accurate 
methods for determining the vocational aptitudes of the 
youth of our land. Those children who give evidence 
of psychopathic derangements should have the oppor- 
tunity of being referred to psychopatliic clinics. There 
will be so much need of dental clinics that they should 
be co-ordinated with the regular medical work. But we 
may further have special arrangements for orthopedic 
work, also in connection with open-air classes and schools 
inasmuch as many of the orthopedic cases have a tuber- 
cular character. 

Clinics for Delinquents and Dependents. — A similar 
system of clinics should be operated in connection with 
every children's or juvenile court, morals court, and 
detention home. As a matter of fact, detention homes 
may be utilized as observation clinics. The problem of 
charity for dependent and destitute or ill-used children, 
involves likewise the careful study of the individual case. 
Therefore private charity bureaus no less than municipal 



480 THE EXCEPTIONAL CHILD 

and State charity commissions should provide for edu- 
cational, medical, psychological, and other clinics in 
the same organized manner as has been suggested for 
the schools. The sociological investigations to which 
these agencies usually confine themselves tell only part 
of the story. The best plan will be, as has been rec- 
ommended repeatedly in these pages, to organize all 
this work jointly under the educational authorities. 

Medical Aspect. — In order to exemplify the function 
and importance of medical relief and co-operation in 
solving the problem of the exceptional child, the author 
has invited a number of eminent physicians to con- 
tribute to a "medical symposium," each one to treat of 
this great subject from his own standpoint and experi- 
ence. He has preferred such expressions from experts 
to his own statements, for the reason that this method 
of presentation will make the argument much more 
powerful and convincing. This brilliant symposium is 
given in the Appendix. 



CHAPTER XXIV 

PROVISIONS FOR EXCEPTIONAL CHILDREN IN 
SCHOOLS AND INSTITUTIONS 

Special and Ungraded Classes. — The terms "special" 
and "ungraded" classes have been used interchange- 
ably. They mark the first attempt to segregate children 
who do not conform. 1 But they have been grossly mis- 
used, largely through lack of differentiation. They have 
been a sort of dumping-ground for all those children 
with whom the regular grade teacher does not know 
what to do. 

In some school systems there is a rule that pupils who 
have been for two years in the same grade must be 
moved on to the next higher grade, no matter whether 
they can do the higher grade work or not. Sometimes 
this method works beneficially as, with the progress of 
maturing, the mind of a child wakes up to its higher 
responsibilities. In other schools the opposite method 
is followed. The author has had under his observation 

1 Germany took the lead in this movement as in so many other edu- 
cational and cultural movements. Special classes for mentally defi- 
cient children were established there in 1867; Norway followed in 1874, 
and England, Switzerland, and Austria in 1892. In the United States, 
Providence, R. I., opened three schools for backward children in 1893; 
Boston organized its first special class in 1899. In 1901 the first special 
class was established in the public schools of Philadelphia. Other cities 
followed. In 1911, 220 American cities had special classes for back- 
ward children, although many of them followed the bad example of Eng- 
land in allowing low types of defective children to enter. 

481 



482 THE EXCEPTIONAL CHILD 

children who had been left in the same grade for as 
long a time as five years. These had been forced to do 
the same grind over and over again until they became 
sick of it, or went to sleep mentally, and consequently 
became either obstreperous, or absolutely unresponsive 
to anything — fit only for the human refuse-heap. They 
are saved only if their native power is strong enough to 
assert itself in time, unschooled as it will be under the 
circumstances, and will defy their pedantic upbringing, 
what there was of it. 

Ungraded Classes. — For pupils of this type the "un- 
graded" class can sometimes do much good, provided it 
does not stigmatize them as defectives and does not in 
that manner deprive them of the incentive of self- 
esteem. 

Many of the children now retained in "ungraded" 
classes are in reality mental defectives and ought to be 
in custodial institutions. Many other "ungraded" pu- 
pils would do better in "parental" institutions where 
they would live away from their homes. 

Rightly understood, an ungraded class is one in which 
the ordinary grade requirements are suspended. It is 
best adapted to those children whom the author has 
called pseudoatypical. This class comprises those whose 
progress in school was hindered by irregularity of at- 
tendance, or change of schools; by a slower rate of de- 
velopment without pathological retardation; by a more 
or less uneven development, with more rapid progress in 
some and temporary retardation in other subjects; by 
temporary illness, or by slight physical difficulties, such 
as lameness and minor deformities; slightly impaired 
vision or hearing; adenoids, etc. The "ungraded" 
class will also be of great help to children who have 



SCHOOL PROVISIONS 483 

suffered from neglect; for the children of our immi- 
grants with whom there are difficulties of language ad- 
justment, although they are mentally and instruction- 
ally advanced, or with whom a racially differentiated 
instruction is needed for a while. 

It should be the function of the "ungraded" class 
to restore its pupils as soon as feasible to ordinary school 
conditions. 

Many pupils, for that matter, would make better 
progress even in their regular classes if their teachers 
would recognize their exceptional condition and would 
adjust the work in a measure to their type and rate of 
speed. This, of course, would require much smaller 
classes than is now the rule. But this demand is so 
self-evident for the handling of children in general that 
it hardly needs to be stated. Public schools compare 
very unfavorably with private schools in regard to the 
number of pupils to a class and a teacher. 

Ungraded classes and elastic courses of study require 
a type of teacher much better trained and much more 
professionally dependable than is the average teacher 
of to-day. 

Special Classes. — The "special" class should be dif- 
ferentiated from the "ungraded" class. It may share 
with the latter the distinction of offering opportunities 
for individual observation. As has been stated before, 
it may be desirable in some of the larger school sys- 
tems to have observation classes established to try out 
pupils who offer difficulties of one kind or another, be- 
fore they are placed either in a "special" or an "un- 
graded" class, or altogether into another kind of edu- 
cational institution. But whatever the arrangement 
be, it should never appear as if the placing in any of 



484 THE EXCEPTIONAL CHILD 

these particular types of classes or schools were in the 
nature of a discrimination against a child. It should be 
understood that the special child is being privileged by 
having his opportunity. The circumstance that some 
of these classes in certain school systems have been 
called "opportunity classes" does not take away from 
the stigma of being placed there when they are popu- 
lated by the dunces and defectives of the school. 

Various Types of Special Classes. — The "special" 
class should also abandon the "regular" course of study 
and adapt itself to the needs of different types of chil- 
dren. There may be a number of different kinds of 
special classes, each with different functions to meet 
various needs. In some systems these classes may be 
assembled in separate school-buildings, at least certain 
types of them. 

Here children who are difficult of management may 
find the educational atmosphere more congenial than 
that of the regular class because of the elasticity of the 
course, and because their individual adaptations are 
more readily taken into account. Here the manual 
child, the artistic child, the child of special aptitudes and 
difficulties may find his relief. It will prove an especial 
boon to children of unusually rapid development who 
would feel the burden of mediocrity and slowness in 
the "regular" class too harassing. And of course the 
slow child will welcome the special class where he can 
walk his dog-trot while the quick child runs along the 
race- track. 

Caution, however, is needed here. Children may 
catch the contagion of our present-day post-haste 
method of living. We have lost the contemplative, 
beneficially composed habits of the ancients and of 



SCHOOL PROVISIONS 485 

more primitive races. We have become impersonations 
of the incessant tick-tack of the watch in our vest- 
pockets, which races through seconds and never stops. 
Much of our morbid bodily, emotional, and mental 
tension is due to the hyperstimulated action of our 
heart which emulates the clock. Our life "tempo" 
multiplies normal consumption of energy by ten. All 
phases of our life, all occupations, all our amusements 
and pleasures are permeated and infested by this race- 
course rush. It ruins health and beauty and degrades 
man to be merely a ramming and on-rushing head which 
painfully drags its body behind simply because it can- 
not rid itself of the encumbrance. Children catching 
this racing fever will soon be psychopathic. The ner- 
vously bright child, the precocious child, has no place 
in a special class where his already overstimulated brain 
will be further edged on. He ought to be in a sanatorium 
school. 

Professor Yasusaburo Sakaki, of Tokyo, quoted in 
the chapter on exceptionally bright children, page 138, 
says justly: 

Our experirhents and their results served to convince us that 
there is urgent need for reform in the present system of class- 
making, for this system renders it difficult to differentiate indi- 
vidual children, and consequently those who stand most in need 
of judicious and expert handling are neither recognized as such 
nor likely to receive the training and education adapted to their 
special requirements. 

Institutions for Atypical Children. — Sometimes, in the 
homes of the wealthy, atypical children (and those of 
the subnormal group as the author has enumerated as 
of arrested and rudimentary development) are placed 



486 THE EXCEPTIONAL CHILD 

under private tutorship. This is rarely satisfactory, 
since the study and better understanding of these cases 
is a matter of profound scientific research and much ex- 
perience. Besides, the method of private tutorship de- 
prives the children of the benefit and stimulus of com- 
panionship and healthy competition. 

Atypical children, needing sanatorium treatment and 
training; children morally or emotionally unbalanced, 
and those where there is suspicion of arrest of some of 
the faculties, cannot be successfully handled in day 
schools of any kind, or while they are living at home. 
There would always be the struggle between the home 
and the school environment for the dominant influence 
in the child's development. In the home there is usu- 
ally nervous and emotional tension which affects these 
children who may be considered the cause as well as 
the product of this condition. Their parents seldom 
find the right angle of vision to contemplate their needs. 
Harmony of educational methods and control is practi- 
cally impossible when the child pendulates from one 
set of environmental influences to the other. This 
struggle will be present also under private tutorship in 
the home. In this way the child will never gain an 
equilibrium of habits and attitude. Besides, the proper 
training of these children is only secondarily a matter 
of instruction, and requires primarily a detailed care of 
the physical and emotional development; in other words, 
a well-systematized re-education, a well-regulated gen- 
eral regimen in mental and physical exercise, in habits 
of life, in diet, sleep, etc. 

Hetherington's "Play School" (cf. pp. 445 jf.), which 
was a day-school experiment, can well be organized in- 
stitutionally; the principles would be the same. 



SCHOOL PROVISIONS 487 

As to Methods in Special and Ungraded Classes. — 

The clinical findings as described in Chapter XVI will 
give valuable hints as to the kind of training a child 
should receive in a special or ungraded class. 

If it is found that there is lack of memory-power, 
special exercises in attention, concentration, and mem- 
ory must be devised. If the child lacks keenness of 
visualization, attempts should be made to develop this 
power. Of course not all such training will succeed, 
but we must at least try to lead the child along the road 
where he must go. If he does not respond, let us ob- 
serve where he can go and make his steps as secure as 
we can. In most cases the mind of the child needs a 
new start, being bound up in false habits of thought, 
feeling, and action. We must go back to first principles, 
so to speak, and re-establish simple life-conditions and 
experiences. The child must build his own experience, 
not lean on others vicariously; only in this way will he 
build for himself a conceptual world all his own, and 
live his true life. This process will require time, inas- 
much as the re-education usually has to begin after the 
period of unconscious absorption is passed. The con- 
scious effort which has to be made by the child to re- 
establish simple conditions acts as an obstruction to 
quick response and new habituation. 

It is, therefore, of importance to utilize the natural 
instincts and the play element in the child as points of 
vantage; his " paradise of childhood" must be re- 
established for him. The great world with its wonders 
must not only be brought close to the schoolroom, but 
the child must be taken out into it, like Whittier's 
"Barefoot Boy." This does not imply at all that the 
child should lose himself in idle play and pastime. He 



488 THE EXCEPTIONAL CHILD 

will learn spontaneously the satisfaction which comes 
from application to hard work. 

Great stress must be laid on motor training, through 
physical and manual culture. Motor exercise (educa- 
tionally as well as historically, in the development of 
the racial instincts and impulses) is the foundation upon 
which the entire mental and moral superstructure rests. 
All our intellectual and ethical measures and standards 
are based upon these primordial instincts and activities. 
Physiologically speaking, motor expression is connected 
with every activity of the brain, the majority of the 
cells of which are motor centres. 

It would seem unnecessary to state expressly that, in 
the matter of instruction generally, objective methods, 
adjusted to the needs of the individual pupil, must be 
employed. As a matter of fact, there is no "special" 
method for a special class or school; what we need is 
the individualized application of rational principles of 
method, such as are essential in all school work and for 
all children, in a manner which will reach the "special" 
child. It is a matter of emphasis and gradation, of 
regulated speed, of careful attention to the details of 
successive steps, of the avoidance of sins of omission 
and commission, etc. 

In the matter of discipline, 1 firmness and gentleness 
must combine to produce in the child a wholesome 
growth of moral habits and principles. A moral life, at 
least in its lower terms, is largely a matter of well- 
regulated habits of action and reaction. The problem 
of discipline is often thought to be a problem of training 
a child in obedience. But the author ventures to main- 
tain that it is wrong on the part of an educator, parent, 
1 Cf. "The Career of the Child," chap. XVII. 



SCHOOL PROVISIONS 489 

or teacher, to expect obedience. Obedience is not an 
innate moral quality. Obedience in the ordinary sense 
is a subjugation of the child's will under that of the 
stronger adult. It is no virtue whatever. The "obe- 
dient" child is either weak or in danger of becoming a 
hypocrite. Naturally the child is not "obedient" at 
all. What the child has got to learn is, first of all, con- 
fidence in his educator, so that he would follow his lead 
through the belief that his teacher or parent knows 
best. Again, the child is as much an independent per- 
sonality as his educator, and must learn through his 
own experience, in the companionship of his elders 
whose chum he is. They must go together through these 
experiences which the wise educator will manage to 
make typical, following the lead of the child's own in- 
stincts and interests. Let us be reminded of the culture- 
epoch evolution of the child, so that this injunction be 
fully understood. Further, the child should have an 
opportunity of learning to concentrate his attention 
through the awakening of his normal instincts in the 
right sequence of budding periods, and to respond in- 
stantly to proper stimuli. His mind should become an 
ordered domain, where all details are organized and 
co-ordinated. "Obedience" will then take care of it- 
self. Whenever a child is "disobedient," let us find 
out what the matter is with ourselves, rather than 
punish the child. 

That of which the child does not possess the poten- 
tiality, of course, cannot be accomplished, and the secret 
of training the special child consists in understanding 
his individual case, the causes and conditions of his 
individual combination of abilities and weaknesses, tak- 
ing him on his own terms. In other words, his training 



490 THE EXCEPTIONAL CHILD 

is a process of eliminations and substitutions, and of 
concentrating the child's attention upon higher motives 
of action. 

Power of attention is practically identical with the 
power of self-direction, of voluntary effort, of will-power. 
But you cannot give to anybody the will to do. You 
may give him the physical strength and nerve force 
which will form the foundation and prerequisite of vol- 
untary effort, and without which, effort and the psycho- 
logic development generally would lack their physiologic 
substratum and counterpart; but you cannot supply the 
will itself. That must come from within the child's 
own soul. All you can do is to supply the motive power 
for the exercise of voluntary effort. The most effective 
agents for the production of this motive power are inter- 
est and joy. There is no action without an emotion; 
emotion is first, releasing the motion. Joyful exercises 
inspire the child with self-confidence, so that he will 
overcome morbid fears and shyness. Many atypical 
children have fallen behind the others, not from inherent 
mental weakness, but from a morbid self-consciousness 
and timidity. Not that you should be sentimental and 
gushing in your joyful efforts. A little wholesome rigor 
and sternness will serve as an effective tonic for the dis- 
organized minds and wills you have occasionally to deal 
with. But all efforts must concentrate on giving the 
child confidence in himself. To accomplish this you, as 
his educator, must first believe in him so that you may 
inspire him with your own enthusiasm. 

These suggestions, of course, do not fit only the work 
in the special day class, but also the work in institutions 
devoted to various types of exceptional children. 1 

1 The Boston public schools have issued a syllabus for special classes 
which offers valuable suggestions for all special work. Although the 



SCHOOL PROVISIONS 491 

Truants and Incorrigibles ; Juvenile Delinquents. — 

The problems of these classes have been discussed in 
various chapters of this book. A few practical sugges- 
tions and statements may be added. 

First, attention may be called to the valuable publica- 
tion of the United States Bureau of Education (Bulletin 
No. 2, 1914) on " Compulsory School Attendance" re- 
ferred to before. W. S. Deffenbaugh, the bureau's 
specialist in school administration, has written the first 
paper in this bulletin. The entire paper is of the great- 
est value to the student of this problem. Among other 
things Mr. Deffenbaugh refers to a new kind of officer, 
the "school visitor" or " visiting teacher," who has 
become one of the efficient means in some cities for 
securing regular attendance at school. He quotes Miss 
Mary Flexner, who has made a recent study of the work 
of these officers: 

The visiting teacher was created to bridge a gap in the exist- 
ing school machinery. Her province lies outside that of the 
regular teacher, the attendance officer, and the school nurse, 
though, like the attendance officer and the school nurse, she 
goes into the child's home. To her is assigned the group 
called the "difficult" children, and it is her aim to discover, if 
possible, the cause of the difficulty which manifests itself in 
poor scholarship, annoying conduct, irregular attendance, or 
the need of or desire for advice on some important phase of life. 
It is too much to expect the regular teacher, handicapped as she 
is by her large class, to cope with such situations. Nor is it to 

backward, even the mentally defective child is considered first in this 
syllabus, the work outlined fits admirably into courses for potentially 
normal, derailed, neglected, delinquent, and other classes of special 
children. Of course only in its broad outline; the adjustment will have 
to be made to fit the case. The syllabus contains directions for manual 
work, art-work, domestic science, games, entertainments, folk-dancing 
and gymnastics, nature, language, number, reading, penmanship, spell- 
ing, and sense training. 



492 THE EXCEPTIONAL CHILD 

be expected that those qualified to act as attendance officer or 
school nurse, were they not already burdened, should do the 
work of the visiting teacher. In her is united the training that 
makes a teacher and a social-service worker, and it is because 
of this combination that she is able to widen the regular teacher's 
reach and help her to interpret and solve the problems as they 
present themselves. From the school she learns that the child 
is apparently making little effort, that his work is "C" or worse, 
or that he is perpetually making trouble in the classroom and 
is never attentive, or that he seems lifeless, unable to keep pace 
with the class, or that he attends so irregularly it is impossible 
to teach him anything, or that he has not time to study, and 
the situation at home is such that he must leave school and go 
to work. 

With these facts as clews she sets to work; it is impossible to 
define her methods, for they vary with her tact, her resource- 
fulness, as with the specific character of the problem before her. 
Briefly, they are the methods that spring from a friendly inter- 
est, an intimate personal relation. 

Between the home and the school the visiting teacher vibrates, 
carrying to the former the school's picture of the child, and re- 
turning to the school to reinforce that impression or to shed 
new light upon the problem. There is no fixed number of times 
that she travels this path, as there is no fixed hour of the day. 
The urgency and complexity of the situation alone determine 
her movements. Nor is there any regular routine of action 
that she follows. Whatever in her judgment seems imperative 
she endeavors to effect, using to this end everything that the 
ingenuity of man has devised to make smooth the rough places 
in life. It is a focusing of interests that she demands. The 
child is the pivotal point on which she hopes to bring all her 
knowledge and experience to bear. Sometimes it is the expert 
teacher's training that she invokes; sometimes the psychologist 
or the physician, general or special, that she consults, or again 
it is the social worker to whom she appeals. Before these she 
lays the facts, the reasons why her services have been sought, 
and from them she asks co-operation. 

The results achieved do not always show a complete cure. 
In some cases there has been a marked improvement in scholar- 
ship, conduct, or attendance. At least a good start in the 



SCHOOL PROVISIONS 493 

right direction has been made. In others the child has been 
transferred to another class — regular, special, or ungraded — or 
to a trade school, where his chances at succeeding in making a 
place for himself are increased. In others the information that 
the visiting teacher shares with the child's teacher has resulted 
in a change of attitude on her part or an expansion or contrac- 
tion of the course of study, or in giving the child extra instruction 
in study periods or out of school hours. Finally, he has been 
helped to promotion, even to graduation. 

In the paper itself Mr. Deffenbaugh studies, also, the 
problems of the immigrant, of child labor, or poverty, 
or private schools, etc. He has, as he expressed him- 
self recently in another place, a new conception of what 
a truant officer should be: 

The old idea of the truant officer as a "kid cop" is passing 
away. The new truant officer is a man of entirely different 
type; quite frequently, in fact, a woman. In several cities a 
large percentage of truant officers are college graduates; in 
other cities they are men and women with experience as social 
workers; but whether college graduates or not, they are required 
to know and understand the home conditions of school children. 
Attendance officers of the new type are interested in removing 
fundamental causes of truancy rather than in merely catching 
the offenders. The chief cause of failure to obey attendance 
laws, according to the National League of Compulsory Education 
Officials, is inadequate family life. Resolutions adopted at the 
recent meeting of this organization, therefore, called for "ade- 
quate and uniform marriage and divorce laws for the protection 
of childhood; enactment and enforcement of laws pertaining 
to the issuance of marriage licenses that will prevent child mar- 
riages and prohibit the marriage of persons physically, morally, 
and mentally unfit to wed." x They urge that the juvenile 
courts be given definite authority to place parents as well as 
children on probation for truancy and delinquency; they ask 
better State supervision of dependent children; civil service for 

1 Cf. Chapter XIX. 



494 THE EXCEPTIONAL CHILD 

all truant officers, and the maintenance of parental schools, 
special rooms for truants and incorrigibles, and health inspec- 
tion of schools as material factors in child welfare. The atten- 
dance officer of the new type is to be a far better trained man 
or woman, and is to receive better pay. Superintendents of 
some of the largest school systems in the United States joined 
in advocating a minimum salary of $100 per month, with ser- 
vices for twelve months in the year, in order that the officers 
may be in constant touch with the home conditions of the boys 
and girls. 

Some of the remedies suggested may not touch the 
root of the evil, although all of them deserve attention 
and discussion. It must not be forgotten that the regu- 
lation of marriages is a two-edged sword; again, that 
many boys (and girls) play truant and are "incorrigi- 
ble," because the routine of the school does not appeal 
to their special type and genius. 

In his "Conclusions," at the end of his paper, Mr. 
Deffenbaugh states the following demands as the most 
important factors in the enforcement of compulsory 
education laws: 

i. An annual school census taken by the school authorities 
of the city or district. 

2. Prompt reports by teachers of public and private schools 
of all absentees not legally excused. 

3. Properly qualified attendance officers who give all their 
time and attention to the enforcement of the law, and also 
school visitors in cities having a large foreign or negro popula- 
tion. (?) 

4. State agents to see that the laws are enforced. 

5. Special schools for truants and pupils irregular in atten- 
dance. 

6. Relief for indigent parents having children of compulsory 
age. 

7. A definite annual period of attendance. 



SCHOOL PROVISIONS 495 

8. Well-enforced child-labor laws. 

9. Employment certificate made to employer, and not to be 
used by child when seeking a new position. 

10. Proper penalties on all concerned in the enforcement of 
the law. 



The suggestions contained in the foregoing paragraphs 
apply also on a large scale to the treatment of youthful 
offenders. A large proportion of the criminals are boys 
of 17 or 18, who, as Judge Edward Swann, of New York, 
says, in the eyes of the law are "infants." 

The old idea of the "reform school" as a penal institu- 
tion is passing away. The youthful offender must be 
considered as an undeveloped, underdeveloped, handi- 
capped, or derailed individual, whose chances in life 
should be carefully studied. His treatment is an edu- 
cational problem, not a judicial one. For this reason it 
must be made dependent upon a clear diagnosis of the 
educational status of the individual offender, who should 
not be looked upon as essentially different from the boy 
or girl who subjects himself or herself to measures of 
parental or school discipline. This view-point has been 
fully discussed in various chapters in this book. Says 
Professor Thomas H. Haines, in the article quoted be- 
fore: 

There will result a new conception of the work of our reform 
school and also a new conception of the work of its field offi- 
cers. The reform school is not to be expected to overcome 
native defect, but it is to be an experiment station trying out 
doubtful cases, ascertaining what retardations may be over- 
come. The field officer is to be a very highly trained practical 
sociologist, skilled in all the arts of guiding into proper lines 
the forces of socialization. His is to be the art of making per- 
sonalities. 



496 THE EXCEPTIONAL CHILD 

And Doctor Healy, of Chicago, in an article in the 
Journal of Educational Psychology, May, 191 5, entitled 
"An Outline for Institutional Education and Treatment 
of Young Offenders," gives his first two main points as 
follows : 

A. The entire aim of the activities of a training school for 
delinquents is. to fit the individual to cope with all phases of 
an ordinary social environment. 

B. The human material to be worked on in this type of an 
institution must be selected for it by prior diagnosis. Uneduca- 
ble persons do not belong therein. (Under the exigencies which 
some institutions have to meet, mental defectives are accepted, 
but, of course, needs of defectives are only to be fulfilled by giv- 
ing them special discipline and education, with which we are 
not here concerned.) 

All this sounds different from the traditional attitude 
toward the unsocialized elements which rub up against 
the laws of organized society. It stands to reason that 
these will never be socialized if they are handled as out- 
casts and moral lepers. 

Abnormal and Feeble-Minded Children. — The segre- 
gation of an abnormal and feeble-minded child in sepa- 
rate classes in day schools does not solve his problem at 
all, not even during the prepubescent period, when he 
(of, rather, she) is said not to be dangerous or in danger. 
Outside of school hours he mingles with his normal 
fellow pupils, and with children in general in his parental 
environment. This benefits neither the abnormal nor 
the normal. And when he can no longer be retained in 
his special class, having passed the age of compulsory 
school education (if this reaches him at all) ; after all the 
money and time and energy the school has spent on 
him, he still remains feeble-minded or degenerate, and 



SCHOOL PROVISIONS 497 

must be segregated from the body social. In other 
words, he is just as much a burden to society as if he 
had not gone "to school" at all, and the money spent 
on his schooling cannot be considered in the light of an 
investment. 

It has been pleaded that inasmuch as there are as 
yet very insufficient provisions for placing feeble-minded 
and abnormal children in institutions for custodial care, 
they should at least be segregated in special classes. 
As a makeshift such an arrangement may pass, provided 
the feeble-minded are not, in these classes, mixed with chil- 
dren of other types. But we must face the issue squarely 
and state the case clearly. 

In the first chapter of this book, and repeatedly in 
other places, attention has been called to the fact that 
these children, unless properly taken care of in time, 
will be a burden to society anyway, with a dispropor- 
tionate cost of maintenance, in almshouses, poor farms, 
reformatories, prisons, and with a tremendous apparatus 
of police, courts, charity and correction commissions, 
etc., to boot. Properly placed from the beginning, they 
will reduce the cost of their presence in society enor- 
mously. In the following paragraphs just a few of the 
arguments sustaining this contention will be given. 

The plea has been made that the finances of the com- 
monwealth do not allow the establishment of custodial 
institutions rapidly enough. It can be shown that the 
money which is being expended for special classes for 
these unfortunates is wastefully greater in amount. 
Let us calculate. 

In the State of New Jersey, for example, the average 
cost per pupil, calculated on enrolment, including inter- 
est on investments, is about $35 per annum, that is to 



498 THE EXCEPTIONAL CHILD 

say, for the ten regular school months. 1 According to a 
recent State law, classes for the "mentally defective" 
are to be formed which should have no less than ten and 
no more than fifteen pupils each. The usual number of 
pupils in a regular class varies, but is certainly at least 
three times as high as that in the " defective" class. 
This alone would mean that each pupil in such a special 
class would cost about three times as much as an " ordi- 
nary" pupil, making the average per capita cost at least 
$105. The State, however, pays an extra bonus of $300 
for each teacher of such a special class, which raises the 
per capita cost to at least $125. Figuring on the basis 
of twelve school months, as we do in institutions, it 
would raise the minimum expense to $150. The aver- 
age expense per inmate of the Vineland Training School 
is given as a little more than $250; figuring the interest 
on the investment would raise this to about $290. The 
Vineland School, with its relatively small number of 
inmates and model equipment, is comparatively expen- 
sive as compared with the $216.64 which is the per 
capita cost in the Massachusetts Institution for the 
Feeble-Minded, at Waverley. The figures for the New 
York State Institution at Syracuse are similar. Quoting 
from Doctor Helen MacMurchy's ninth report (1914) 
on the feeble-minded in Ontario: 

In a well-organized and well-managed County House of 
Refuge, on a good farm in Ontario, the weekly cost per inmate 
varies from $1.50 to $2.5o, 2 according to the fertility of the 
land, the type of building and equipment, and the thrift, skill, 
and knowledge with which farming and housekeeping are car- 
ried on. 

1 In some school systems, as in Newark, the schools are now open all 
the year round. 
5 Or $78 to $130 per year. 



SCHOOL PROVISIONS 499 

In an industrial farm colony for mental defectives those un- 
der the mental age of 3 years (formerly called idiots) are not 
able to do much. The middle grade and high grade may be 
taught to pick the stones of a field, and carry things from one 
place to another under direction, and these occupations have 
some commercial and industrial value. All those of the men- 
tal age of 3 to 7 years (formerly called imbeciles) can contribute 
something to their own maintenance, and in many of them 
there resides some ability, which should be found out. Their 
powers are frequently sufficient to enable them to partly earn 
their own living under good supervision in an institution. 

Permanent care in a suitable institution is the only successful, 
economical, and humane method of dealing with mental defec- 
tives. . . . 

In the best institutions of this kind the industrial work grows 
more practical every day, and thus better and more economical 
administration is secured, as well as more satisfactory training 
of the children. 

They should do all their own work, make and mend all their 
own clothes, weave the cotton, linen, and woollen materials used 
in the institution, make their blankets, produce vegetables, 
flowers, and fruit, and food products of all kinds, and learn 
every industrial trade and other employment that can be made 
useful in their own or other institutions, especially those relating 
to food, clothing, agriculture, and building. 

At Darenth Industrial Colony, Dartford, England, the fol- 
lowing estimates have been made: 

Forty-five feeble-minded women can do the laundry work 
which twenty normal women (good laundry workers) can do. 
Taking a rough average of all kinds of occupations, four feeble- 
minded persons can do the work of one normal person. 

Doctor Fernald, Waverley, Mass., has shown that in an in- 
dustrial farm colony for mental defectives strong, able-bodied 
men can practically earn enough to support themselves, if a fair 
market price is received for the farm produce. 

In Vineland there are from ten to fifteen inmates, one em- 
ployed in the school, one in the engine-room, one in the shops, 
and a number on the farm, each of whom does the work that 
otherwise would have to be done by a normal person. . . . 



500 THE EXCEPTIONAL CHILD 

As a matter of fact, as has been shown in the chapters 
on efficiency and on the feeble-minded group in this 
book, "high-grade" feeble-minded may, under custodial 
care and supervision, reach a high grade of skill in vari- 
ous occupations, such as lace-making, printing, weaving, 
etc., which would give their products a market value 
above the cost of their maintenance. 

The following figures will assist in understanding the 
relative cost of special classes and custodial institu- 
tions : 

Taking the figures given above as a basis, the annual 
rate of expenditure for one "defective" pupil would be 
$105; for an entire class of 15 this would mean an annual 
outlay of $1,575. It will require $3,150 to care for 30 
pupils for ten school months; $6,300 to care for 60; 
$12,600 to care for 120 children. This money will easily 
allow the purchase of a small farm and the erection of 
buildings to start a colony with. Maintenance, includ- 
ing interest on the investment, in the succeeding years 
will be considerably cheaper than the maintenance of 
the special classes, and the saving will soon become 
evident. 

More than that. In a city having a school population 
of 100,000 there may be a maximum of 2,000 abnormal 
children of all kinds, roughly estimated. Even if we 
should count the cost of each individual " special class " 
defective only at an even $100, this would imply the 
expenditure of $200,000 annually, if all of these were 
cared for in special classes. The enormous economy if 
custodial institutions and farm colonies would be es- 
tablished for them is at once evident. And if they are 
not cared for? This book gives the answer to this 
question on almost every page. 



SCHOOL PROVISIONS 501 

Special Provisions. — Some municipalities have already 
included in their school system special classes, or day 
schools, for blind, deaf, ancemic, tuberculous, and crippled 
children. If the latter are tuberculous, they will share 
the provisions made for that class of children. With 
those cripples who are not tuberculous it is largely a mat- 
ter of transportation to and from school, and of adjust- 
ment of the school curriculum. For the anaemic child 
and, of course, also for the tuberculous patient, the open- 
air school is the ideal provision. Some of these open-air 
arrangements are in the form of roof-gardens; others are 
tent colonies in open spaces; still others make use of 
barges floating on rivers and lakes. The school work 
itself must take the limit of physical strength and en- 
durance in these children into consideration. The work 
done in New York may be considered an example. 

The blind and the deaf have heretofore been segre- 
gated in institutions. This method of providing for 
them has recently been superseded in many places by 
arrangements through which they are accepted into the 
regular classes under special regulations. This gives 
them the opportunity to adapt themselves to natural 
life conditions such as they will have to battle with in 
their struggle for existence when grown up. This ar- 
rangement, however, presupposes a home training of 
these children before they are of school age. Where this 
training cannot be given in the home it should be given 
in special institutions or home schools. The Inter- 
national Sunshine Society has done some pioneer work 
with blind babies. The most remarkable and, indeed, 
leading work for the training in speech of deaf children 
before they are of school age has been done by the Gar- 
rett sisters in Philadelphia. Their Home School, since 



502 THE EXCEPTIONAL CHILD 

1893 conducted by Mary S. Garrett as a Pennsylvania 
State Institution, has done a very great amount of good, 
and has shown the way for the true solution of the 
problem. 

Of course when a blind, deaf, crippled, or otherwise 
physically defective child is found to be also mentally 
difficult, his case requires adjustment to that condition. 

The New Jersey Commission for the Blind maintains a 
department for the home teaching of the blind, having 
ministered to 266 blind persons scattered throughout 
the State in 191 2-13. There is also a department of 
investigation and prevention. The commission, in its 
report for 19 13, made the following typical recommen- 
dations: 

Family care and normal life for the blind of all ages in pref- 
erence to institutional care and segregation. 

(a) The blind baby should be properly trained in its own 
home, with the help of the district nurse, friendly visitor, and 
home teacher. 

(b) The blind youth should be educated in special classes in 
the public schools in preference to residential schools. 

(c) Blind adults should be trained and given opportunities 
for industrial self-support in their own homes, rather than 
segregated in State industrial homes. 

(d) The deaf blind, both youth and adult, should have indi- 
vidual instruction in their homes. 

(e) The epileptic blind should be provided for in their own 
homes or in boarding homes of the sighted. 

(/) The destitute blind should be provided for in their own 
homes or in boarding-homes of the sighted. 

The Vineland Training School should be equipped to train 
the feeble-minded blind of the State. 

In this schedule of suggestions there seems to be one 
self-contradiction. If the feeble-minded blind are to be 



SCHOOL PROVISIONS 503 

trained in an institution for the feeble-minded, why 
should the epileptic blind not be transferred to the 
colony for epileptics? 

Otherwise the suggestion that the blind, like the deaf, 
should be trained in a manner which will give them 
from the start a habituation to natural conditions, so 
that they may be better equipped for conducting their 
life in the world of the non-defective, is most sound. 

It would seem hardly necessary to refer once more 
to the case of Helen Keller, who, in her wonderfully in- 
spiring life, has demonstrated the truth of these conten- 
tions so powerfully. Another equally handicapped 
girl, Kathryne Frick, of Harrisburg, Pa. (Case 76), deaf 
and blind, now 18 years of age, has been similarly trained 
at the Pennsylvania Institute at Mount Airy. She has 
learned to speak clearly and to write a good English; 
she reads the classics, is generally well read, runs a sew- 
ing-machine, threading her own needle, and is a wizard 
with her fingers. 



CHAPTER XXV 

SANATORIUM SCHOOLS FOR ATYPICAL CHILDREN 1 

Purpose of the Sanatorium School. — An institution for 
atypical children should be a homelike school where the 
children live all the year round. 

It must attempt, first, to understand the child, his 
tendencies, characteristics, or genius; second, to place 
him in harmony with the world around him by suitable 
adjustment in the educational environment; third, to 
encourage and develop those aptitudes in him which 
will best prepare him for independent existence in later 
life, training him to reach his highest performance level 
of skill and efficiency. 

Tests and Records. — Before a pupil is enrolled, his 
previous history must be carefully studied. Also, physi- 
cal and mental tests of the order described in this book 
must be made, so that there be no guesswork in recog- 
nizing his real needs, and no haphazard plans for his 
education. These examinations need to be repeated at 
regular intervals; the body measurements as often as 
once a month. 

All work with the child must be based upon a close 
correlation of educational and medical science. 

A careful record should be kept of each pupil's devel- 
opment, sleep, baths, diet, exercise, etc. Whatever ele- 

1 Some of the suggestions contained in this chapter are derived from 
the practical work done at "Herbart Hall," Plainfield, N. J. 

504 



SCHOOLS FOR ATYPICAL CHILDREN 505 

ments may in any way affect the physical or mental 
health must be carefully studied. The pupils may be 
divided into small groups both for "school" training 
and for "home" training, and will have to be regrouped 
and readjusted frequently to meet the changing condi- 
tions. 

All members of the staff, whether they be teachers or 
caretakers, or even other employees (those who are 
intelligent enough to make observations), must be ex- 
pected to make frequent reports covering the pupil's 
mental and moral conduct, his health, etc. These re- 
ports are best made on cards, which are easily carried 
and filed. Every interesting observation is supposed to 
be recorded: the pupil's personal habits, visits at home, 
visits from parents or relatives and friends, and all 
occasions that make up the history of the child while 
under observation and training. The object is to estab- 
lish a continuous child history, which may furnish data 
for a better understanding of the individual case. It is 
required that these reports should contain facts, not 
opinions. All judgment of a child's conduct or condi- 
tion ought to be held in abeyance until reports, covering 
the various phases of the child's life, are collected to 
insure accurate and impartial analysis of the various 
factors operating at a given time. For example: a 
child's unresponsiveness in class, which to the teacher 
may appear as laziness or lack of interest, or again, 
troublesomeness apparently requiring discipline, as- 
sumes an entirely different significance when it is 
known that the child has had a sleepless night or has 
been constipated for days. 

Monthly reports may summarize a child's progress, 
difficulties, or retrogression. 



506 THE EXCEPTIONAL CHILD 

Daily Life. — The atmosphere of a healthy family life 
must be carefully preserved. It is best not to have 
dormitories, but small rooms for one or two, or the 
cubicle arrangement which is found in some of the best 
private schools of the country, e. g., at the famous Gro- 
ton School. A child should be encouraged to develop 
an individual atmosphere in his own room, with pic- 
tures, toilet necessities, hangings, and decorations of 
his own. Birthdays and all festive occasions which 
usually brighten up homes and communities may be 
celebrated in the old-fashioned manner. Such a home 
atmosphere will entwine the sentiments of the children 
around their school home, giving a natural and happy 
life content, such as rational treatment in the ordinary 
home and school will supply under natural conditions. 

The daily personal life of the child should not be in- 
trusted to the care of a mere attendant who is an un- 
trained menial, but should be under the supervision of a 
caretaker who has had educational training. 

Discipline should be based upon a clear and fair un- 
derstanding of conditions and motives, coupled with a 
consistent and constructive attitude. There should be 
a distinct effort to develop an ethical perspective and 
a moral atmosphere. Each child must be trained and 
encouraged to develop his own individual interpretation 
of life in terms of service. 

The school lessons should be adjusted to the fatigue 
curves of the day, considering the hours when mental 
alertness is at its maximum or the reverse. Outdoor 
work should be done whenever possible; even the more 
formal lessons will gain from open-air arrangements. 

Physical training, including eurhythmies, nature 
study, art, and manual training, gardening, etc., must 



SCHOOLS FOR ATYPICAL CHILDREN 507 

alternate systematically with seat work and book-lore. 
The play and the dramatic instincts must supply the 
motive in most instances to appeal to the vital interest 
of the child. On the other hand, the child must learn 
the joy derived from overcoming obstacles, even if these 
obstacles were his own lethargy or lack of interest. He 
will easily be convinced that many a task which looms 
up forbidding and uninteresting to him may reveal hid- 
den beauties and powers — and its conquest may unfold 
to him unexpected possibilities of his own mind and 
body. This method of testing a child's strength and 
self-control to its limits is, however, very different from 
the old idea that there is virtue "per se" in having a 
child do a task just because it is loathsome to him. 

The lessons, occupations, exercise, diet, and general 
regimen must be carefully planned for each pupil. In 
the matter of school work it is best that the work, on 
the basis of a general outline as suggested later in this 
chapter, be regulated weekly in advance by each indi- 
vidual worker. These advance plans should be very 
much in detail, so that the principal may look them over 
for criticism and suggestions. Comparing the new work 
as planned with the work which had been accomplished 
the previous week, together with the principal's visits 
to the classrooms and inspection of children's work, 
gives immediate opportunity for checking up and read- 
justing work and method to individual cases. As soon 
as it is noticed that the child does not respond as was 
expected, the subject-matter, the method of presenta- 
tion, the personality of the teacher, etc., not to forget 
the physical and hygienic side of the problem, must be 
subjected to analysis. Failure on the part of a child 
should never be primarily placed at the child's door. 



508 THE EXCEPTIONAL CHILD 

Outside of the set lessons, the groups, under careful 
supervision and guidance, should have ample opportu- 
nity for work, games, and occupations. Like the work 
in the school, the free time must be carefully planned 
and organized, enlisting as far as possible the spontane- 
ous interests of the children. Every game, every occu- 
pation, every walk or excursion should have an object, 
and were it only that of organized exercise or, for that 
matter, systematized observation. There should be no 
waste of time or energy. This is the very secret of train- 
ing for efficiency. The children should be kept con- 
structively busy all the time. Individual tendencies, 
interests, energies, and other attributes must be given 
expression in a manner which will best suit the pupil's 
need and contribute to the activities of all. Of course 
the children must be largely unconscious of the under- 
lying plan. Much depends upon the skill and ingenuity 
of the teacher to make the chosen games and occupations 
spontaneous. There should be also excursions to facto- 
ries, to historic places, to points of interest and pleasure, 
etc. 

INSTRUCTION AND METHODS 

No Patent Methods. — The question has often been 
asked of the author: "What particular methods do you 
use in educating and teaching exceptional children?" 
There is a feeling among those unfamiliar with work of 
this kind that special methods of instruction, based on 
entirely new principles, or some sort of patent prescrip- 
tion, must be employed with these children. This is a 
misconception. Most of "these children" are, anyway, 
just children in need of a better understanding of their 
needs. It is necessary that teachers "specializing" with 



SCHOOLS FOR ATYPICAL CHILDREN 509 

these "unusual" types (in reality they are quite usual; 
that is to say, many of them are) have a broad 
and thorough knowledge of educational principles and 
methods in general, such as are used with "ordinary" 
children. Also, a teacher must be resourceful, and be 
in full command of his "stock in trade." He must be 
able to rearrange and readjust his methods and princi- 
ples instantaneously so as to fit an individual case at a 
given moment. More emphasis must be laid on some 
reactions than upon others. The factors of emphasis 
and individual adjustment are the real secret of suc- 
cess. 

Objective and Creative Methods. — Generally speak- 
ing, the objective and creative methods are most ef- 
fective. And the emphasis must be on experience, not 
on book-learning. It is a common error in dealing with 
children to take too much for granted. Word knowl- 
edge and memory are confused with a knowledge of 
things and realities, also with judgment. It is impor- 
tant, first of all, to definitely circumscribe the real mind 
content of each child. Having established the apper- 
ceptive basis, the danger of overestimating a child's 
actual knowledge, or of underestimating his power, is 
avoided. Each child must be taken at his own terms. 
The school environment must be so organized as to 
permit quick adaptation to changing needs, to the men- 
tal caliber and to the gait of the individual. 

Native Experience. — The various branches of instruc- 
tion are so many phases, or facets, of world knowledge, 
serving also as points of vantage from which to survey 
and interpret human experience. The experiences of 
the child himself form the focal point in which the 
teacher, as mediator of the world of experience and 



510 THE EXCEPTIONAL CHILD 

reality, must concentrate its rays as upon a periscopic 
lens. 

It is a common error to give a "definition" as a start- 
ing-point for a new thought. In reality a definition is 
the highest form of abstract qualitative analysis. There- 
fore it represents the culmination of human knowledge. 
To give this first is to give what a child can least com- 
prehend. His ability to retain a definition depends 
upon memory, not upon understanding. It is far more 
valuable to the child to form his own concept, even if it 
be incomplete and incorrect, than to make him accept, 
upon faith and authority, the clearest crystal of human 
wisdom. Under guidance he can later check up and 
correct his own imperfect ideas through increased experi- 
ence, and by comparison with the concepts of others. 
To accept the wisdom of the ages is not the first step in mind 
development, but the last. 

One way to clarify the child's ideas is to have him 
clinch each new set of experiences by formulating them 
as exactly as he can in his own words. 

Course of Study. — Naturally the teachers must be 
expected to follow a more or less definite course with 
each child. In an organized school system a definite 
" course of study" is needed. Such an outline, however, 
cannot be specific in its application to groups and indi- 
viduals. It must not pretend to be more than a general 
exposition of principles, methods, and practical aims. 
It can serve only as a working basis for more particular 
directions of adjustment. A combination of the general 
plan and the specific recommendations gives the teacher 
a fairly definite course of action for each child. 

As has been stated before, the teacher must be of a 
mental type which can work over these general and 



SCHOOLS FOR ATYPICAL CHILDREN 511 

particular directions in such a manner that the daily 
and hourly variations of a pupil may be promptly gauged 
and met. While he must know his limitations and keep 
within the general and particular plan, he must not be a 
blind follower of the letter, or a mechanical agent. 

Methods of Presentation. — When the pupil is to have 
a text-book in his hand, as in geography or history, 
the subject-matter should first be developed orally and 
practically. His apperception should be called into 
action, and upon this foundation alone can his further 
progress be built. While it is legitimate to train a young 
pupil occasionally to obtain information from the printed 
page without previous objective presentation, so that 
books may become handy and valuable helpers to him, 
this method of information must not be the rule. The 
subject-matter comes first. The book can serve to 
clinch and systematize the matter discussed and experi- 
enced, and may be used advantageously for review 
work. 

It would be impossible to give here the specific meth- 
ods applicable in individual cases. Also, only a few 
examples of subjects in a general course of study may 
here be briefly described. 

SENSE TRAINING 

Use the songs presented in "Timely Games and Songs 
for the Kindergarten," by Reed-Brockunier: 

"The Bell-Ringer. " (Sense of hearing.) 
"Two Little Windows." (Vision.) 
"The Mystery Man." (Touch.) 
"The Wonderful Bag." (Taste.) 
"The Surprise." (Smell.) 



512 THE EXCEPTIONAL CHILD 

Color and Form. — In connection with gift- work, par- 
quetry, ring-laying, colored papers and paper cutting 
and pasting. Painting in solid colors, also in oil on 
wood, etc. Building-blocks, geometric solids, etc. De- 
velop ideas of temperature and weight — cold, warm, tepid, 
heavy, light. Recognizing materials and goods by 
touch — rough, smooth, silky, woollen, velvety, etc. 
Identifying objects and materials by indirect touch, 
using a stick or other intervening medium. Sense of 
location. All these exercises can be varied in many 
ways, and there is hardly a lesson on the programme 
which cannot, in one or the other of its aspects, be a 
sense-training lesson. Articulation is to be connected 
with acute hearing. 

ARTICULATION 

Articulation should be consistently followed up with 
each child, in school and out. There is hardly a child 
anywhere that should not be improved in enunciation, 
and teachers must never be satisfied with mumbled or 
ill-connected sentences or answers. In the formal classes 
where articulation is the special object sought, the 
teacher should carefully follow the process of language 
evolution (articulate speech) as it has come down to us 
through the centuries. Breathing in the upright posi- 
tion was the primary condition for human sounds and 
articulate speech. Music is one of the first forms 
of expression and is, therefore, important as a starting- 
point. Deep breathing (diaphragmatic) is essential, and 
special breathing exercises form a part of the course in 
this branch, in music, and in physical training. Each 
pupil must have regular drill in vowels at different pitch- 
levels and tone-intensities. This phase of the work may 



SCHOOLS FOR ATYPICAL CHILDREN 513 

be made more interesting by the use of a musical instru- 
ment. The child may eventually learn to carry entire 
tunes, using one vowel sound. With the introduction 
of the consonants, there should be free use of the phonic 
elements and diphthongs. 

In case a pupil shows nervous fear or a tendency to 
stutter while speaking or reading, insist that the child 
take a deep breath before attempting to speak. 

MUSIC 

Music has the fourfold aspect of (i) rhythm; (2) tone; 
(3) melody; and (4) harmony. Being an elemental force 
in civilization, music plays a most important part in 
education and re-education. Not all children may learn 
to discriminate harmony from discord, or to carry a tune. 
Some will never be able to reproduce a musical tone at 
the right pitch, while others have the natural musical 
ear. But all can be trained in rhythm; in fact, rhythm 
is the most fundamental thing in all life processes and 
thought processes, and must therefore be religiously cul- 
tivated. 

In addition to its significance for proper articulation, 
music is the expression of emotion, and as such is worthy 
of the most careful cultivation. Singing should be uti- 
lized for emotionalizing, in a natural and sane way, the 
various aspects of nature, of man's attitudes, aptitudes, 
and aspirations; of occupations and vocations. In con- 
nection with it, dramatic expression should be practised. 
There are motion-songs, dance-songs, etc. 

Simple instrumental music, and if it were merely the 
rhythmic tapping with sticks, or drumming, should be 
introduced to be developed into some form of orchestral 
co-operation. 



514 THE EXCEPTIONAL CHILD 

PHYSICAL TRAINING AND GAMES 

As long as the season allows it, much of these exercises 
should be outdoors. In fact, even brisk winter weather 
is the best thing for outdoor sports. 

i. Exercises in standing erect (the distinguishing char- 
acteristic of man as compared with the lower creation) , 
with chest out, abdomen drawn in, muscles tense. 
Proper standing is very important; it is exercise. A 
consciousness of all muscles is developed, as it were. 
Lax standing is bad in every way. Standing should be 
practised for an increasing number of minutes, beginning 
with fifteen seconds, not longer than two minutes at a 
time, but repeated until pupils have control. Never go 
beyond the fatigue-point, but push that point out far- 
ther and farther. The same rule holds good for all 
exercises. 

2. Exercises in walking and running, with hands on 
hips, or in combination with free and calisthenic exer- 
cises. There are two ways of walking and running: one, 
with muscles tense; another with muscles more or less 
relaxed. 

3. Exercises in complete relaxation. Practice with 
one limb at a time, or with the abdomen alone, the neck- 
muscles alone, etc., until the children know what is 
wanted. Then have complete relaxation (limpness), 
standing or reclining, and partial relaxation in walking, 
etc. This is a very necessary exercise. Nervous pupils 
are apt to be always on tension. 

4. Regular free and calisthenic exercises, with hands, 
arms, legs, including raising of knees, bending of knees, 
tiptoe exercises, wands, dumb-bells, Indian clubs, dance 
steps, etc. Introduce folk-dances. Combinations of all 



SCHOOLS FOR ATYPICAL CHILDREN 515 

kinds, also with walking, running, dancing, etc. Eu- 
rythmic exercises for the free expression of emotions, 
also in dramatic elaboration, are of great value. 

5. Exercises in formation, including marching, lines, 
figures, "Reigen," etc. 

All these exercises can be developed into dramatic 
expression. 

6. Corrective and curative exercises: Breathing, abdom- 
inal exercises (bending, rotating, churning, etc.), bal- 
ancing exercises (with or without arms outstretched) like 
walking along chalk-line, or raised board, on various 
points of support, walking blindfolded, stepping over 
rungs of ladder lying horizontally on floor, etc. Active 
and passive exercises on mat, sitting on chair, etc. Set- 
ting-up exercises, massage, etc. 

The first and principal aim should be to train the 
pupils in prompt, vigorous response, and in proper co- 
ordination. 1 

7. Apparatus-work: This may be given either in the 
indoor or the outdoor gymnasium. It must be system- 
atic, under the supervision and direction of the trained 
teacher, and cautiously used as mere play exercise. 
When properly used it is very helpful. Use trapeze, 
rings, upright ladder, horizontal ladder, parallel bars, 
horizontal bar, climbing pole and rope, see-saw, jumping 
and vaulting apparatus. 

8. Games: Ball games of various kinds alone offer a 
very great diversity of wholesome exercise. Games of 
precision, like the throwing of rings, can be easily prac- 
tised, also outside of the regular gymnasium hour. Chil- 
dren should dramatize what they read and study about 
in their other lessons, in their play activity. Connect 

1 Cf. "The Career of the Child," chaps. IV and XVI. 



516 THE EXCEPTIONAL CHILD 

with camping, sewing, occupations. Build wigwams, 
bridges, etc. These games may assume the character of 
group games, gymnastic dramatization, as in folk-dances, 
etc. Let the pupils play Indians, Eskimos, carpenter, 
birds, etc. This harmonizes with the primitive stages 
in the development of civilization (totem-worship, tribal 
emblems, animal-dances, etc.). Also outdoor games, 
like red rover, fox and geese, puss-in-the-corner, tether- 
ball, croquet, tennis, baseball, simple football, cross- 
country runs. Winter sports: snow forts, snow men, 
coasting, skating, etc. 

ART-WORK 

In regard to this branch of training ("training in civi- 
lization") it seems best to refer to the author's book, 
"Some Fundamental Verities in Education." Here are 
given only a few hints: 

Clay-Modelling of familiar forms and statuettes should 
precede the painting thereof and can be used in connec- 
tion with the teaching of form. The connecting-link 
between modelling and flat painting is : 

Free-Hand Paper Tearing and Cutting, which still deals 
with the mass, this time with the entire surface in solid 
character. This is the first projection of the solid on 
the flat. Shadow and silhouette work. Paper designs. 

Designing and Composition. — This can be introduced 
by the use of blue-printing. Arrange leaves, flowers, 
sprays, even cut-out paper designs, in printing-frames, 
and print. The white designs on the blue background 
may afterward be colored appropriately by the pupils. 
Or they may be cut out and used for stencil-work. Or 
they may be imitated in free-hand cutting and free-hand 
solid painting (in one color). 




Fig. 40. — Blue-print design from nature: Ferns. 




Fig. 41. — Blue-print design from nature: Violets, arranged by pupils. 



SCHOOLS FOR ATYPICAL CHILDREN 517 

Painting. — Use ink-washes, water- colors, oil-paints, 
crayons, without outlines, giving the bold swing of the 
object: vegetables, flowers, plants, vases, still life (Jap- 
anese models). Painting, in dealing with the large mass, 
precedes drawing. 

Drawing. — Use crayons, and large marking and 
drafting pencils first. Avoid outlines, except to mark 
leading points, but give the bold mass and swing with 
large shading. This form of expression is most suitable 
for illustrative work. Throughout the work in all 
branches it is very desirable to have the pupils construct 
imaginative drawings, either original or portraying their 
mental images of incidents in fairy-tales, legends, myths, 
and other forms of folk-lore. Outline-work at this stage 
is in the nature of picture-writing. 

Cutting and Pasting. — Commence with the cutting and 
pasting of pictures, in making scrap-books for geography, 
history, domestic work, nature-work, etc. The pupils 
are expected to make their own scrap-books, sewing 
manila or wrapping paper into books. These may be 
decorated by their own designs. 

Cardboard Construction of familiar objects, like boxes, 
trays, houses, wagons, etc., should be used to introduce 
the third dimension, the concrete concept of volume. 
The objects may then be painted with washes and 
crayon. 

Clay-work may be colored. Designs of Indian or 
other character may be made for pottery. 

Rajfia and Basket Work needs no special description 
here. 

This leads over to other forms of manual work. 1 

1 Cf. "The Career of the Child," chap. VI, "The Manual Principle," 
and chap. VII, "Kinds of Manual Expression." 



518 THE EXCEPTIONAL CHILD 



MANUAL TRAINING 

The foregoing, of course, contains a great deal of op- 
portunity for manual training. The following more 
specific suggestions refer to several definite forms of it, 
more particularly adapted to serve, in addition to their 
general educational value, as a preparation to eventual 
industrial training, or training for manual vocations. 

Shop-Work. — The aim of shop-work is to develop mo- 
tor control in specific forms, and to acquaint the pupils 
with the typical tools (hammer, saw, hatchet, plane, chisel, 
auger, screw-driver, etc.) and the typical occupations. 

Motor Training. — Begin with large movements, pro- 
ceeding but slowly to exercises requiring the activity of 
the finer muscles. Thus, there should be rough work 
at first, with big pieces of wood, and a modicum of 
accuracy. In this group of exercises may be placed the 
rougher type of outdoor work, such as crude masonry, 
levelling of ground, digging ditches, making road-beds, 
garden work, etc. Also large rustic building, making of 
concrete foundations and other structures, building of 
huts, wigwams, houses, and woodcraft of the pioneer 
kind. This is in harmony with the principle of adjust- 
ing training to the culture epoch periods as described 
elsewhere. It corresponds to the early stages and re- 
quirements of primitive, pioneer, and frontier life. 
Thus, it connects the principle of motor training with 
the following: 

Typical Occupations and Tools. — Here enters also the 
element of dramatic representation, as in the kindergar- 
ten games, of the blacksmith, the carpenter, etc. The 
shop leads over to reality. At first the work is only a 
more or less playful imitation of adult activity. As the 




Fig. 42.— Exhibit of pupils' work. Carpentry, basketry, dressmaking 
weaving, etc. 




Fig. 43. — Exhibit of pupils' work. Miscellaneous. 



SCHOOLS FOR ATYPICAL CHILDREN 519 

adult standard of accuracy cannot be understood or 
reached by the child, the ordinary "sloyd" courses are 
contrary to the biological laws of child growth. Just as 
the race has, through industrial development, learned to 
conquer the earth and to produce civilization, the child 
will be helped, through his experience in shop and out- 
door occupations, to reconquer earth's forces for him- 
self and to build up his own world of concepts and 
culture. 

Shop-work, in this sense, is laboratory-work. The child 
becomes acquainted with the nature of materials and 
with the mechanical forces which produce them as 
raw material, and with those other forces by which 
the raw material can be shaped into humanly useful 
things. 

Large work, in the making of rough sleds, sawbucks, 
trellises, etc., will precede the more exact tasks of box- 
making, carpentry, making and mending of furniture, 
setting of window-panes, work in tin, wire, lead forging, 
work on the lathe, etc. 

There will be much opportunity for co-ordination with 
other branches, so as to objectify them, and to make use 
of the child's creative and imaginative abilities to illus- 
trate facts in geography, nature, history, etc. 

A detailed course will depend much upon the composi- 
tion of the groups and upon individual aptitudes. 

Sewing and Needlework. — Both boys and girls should 
have instruction in the occupations that come under 
this head, even though it is supposed that girls should 
specialize in this work. But there are boys who are 
endowed with capacities in these lines (tailors, shoe- 
makers, weavers, etc.), while there are many girls whose 
special propensities lie in other directions. 



520 THE EXCEPTIONAL CHILD 

The first step should be to ascertain definitely how 
much the pupils know about materials, threads, needles, 
threading a needle, kinds of needles for different work, 
kinds of work, such as sewing, embroidering, knitting, 
crocheting, weaving, darning, patching, etc. They must 
understand the meaning of the words, not from defini- 
tions, but from examples. Study materials of which 
threads are made. Kinds of goods: linen, cotton, wool, 
silk, etc. Where and how they are obtained. Use of 
needlework. 

Have the pupils find out all these things as far as pos- 
sible in their own wardrobe, in their room, in the build- 
ing. Have them state and write down the correct name 
applied to each article, the material it is made of, the 
process of manufacture, its use. Find out how many 
of these they have seen being made. Excursions to fac- 
tories, workshops, etc. Mechanical vs. hand produc- 
tion. Looms, sewing-machines, other mechanical con- 
trivances. Arouse interest in developing the ability to 
make things. 

With the girls appeal to the home-making instinct of 
woman. Correlate with the household aspect of the 
work, keeping things going in the home. With the boys 
emphasize the vocational side. 

The work itself must at first be primitive, large and 
coarse. The real sewing as a mechanical art is an after- 
development and not desirable for young pupils. It is 
left to older girls and boys. 

Use shoe-strings with metal ends, the cheapest kind. 
With them the pupils can practise all the different kinds 
of stitches on perforated cardboard. Even the embroi- 
dery and buttonhole stitch can be so introduced. Make 
cardboard constructions on a large scale, like baskets, 




Fig. 44. — Sand-table work. "The lake-dwellers." 




Fig. 45. — Pupils' work. Vocational training-school. Building a house 
with concrete foundation. 



SCHOOLS FOR ATYPICAL CHILDREN 521 

boxes, etc. The aim should be to employ the stitches at 
once in some practical construction rather than to make 
meaningless samplers. 

Lacing and braiding can be taught in much the same 
way. Make mats from torn waste cloth. Crocheting of 
mats. Raffia lends itself well to this work, which is 
related to basketry. String and cord work (making knots, 
tackle of all kinds, connected with the building of boats, 
machinery, and the like) introduces a new thread: coarse 
cord and twine, then the finer grades, leading over to 
worsted, coarse linen threads, finally thin threads and 
silk. 

The use of real needles will be preceded by the use of 
bodkins and darning-needles, using tape, baby-ribbon, 
and other ribbon. All this follows, in modern adapta- 
tion, the prehistoric development of this art. 

Now cardboard constructions may be varied : designs in 
running stitch, overhanding, cross, and buttonhole stitch 
may be made. Make book signs, fancy baskets, mats — 
in silver cardboard and other fancy qualities of card- 
board. 

For sewing proper use first coarse canvas (sack and 
packing cloth), then rough kinds of goods, like denim, 
bag cloth, leading up to coarse cheesecloth, cotton and 
linen, silk, etc. 

Make bags (laundry and sewing bags), doilies, table- 
covers. Introduce a large, life-size doll, for whom a 
trousseau may be made (the furniture to be made in the 
shop, to a scale), including all of a house outfit, like bed- 
ding, bedclothes, mats, carpets, dresses, underwear, etc. 
First use the simplest and coarsest stitches and the sim- 
plest patterns. Even bone needles may be employed in 
the beginning, reproducing the experiences of the women 



522 THE EXCEPTIONAL CHILD 

of the Stone Age. Lead up to more elaborate forms. 
Make all patterns first in paper. 

Dress dolls (smaller size) as Indians, Eskimos, and 
other nationalities or representatives of different occu- 
pations, illustrative of the work in geography, history, 
shop- work, etc. 

Simple embroidery may be applied to these clothes 
and outfits, first in running stitch, later even in raised 
designs. 

The pupils should learn to keep their own clothes in 
order, sewing on buttons, darning stockings, learning how 
to mend and clean their clothes; also how to collect their 
laundry, how to wash, to iron, to fold, and to put away. 
This connects with the household work. 

Huck and Drawn Work on a large scale may be in- 
troduced. Also the making and trimming of simple 
straw hats (millinery). 

Domestic Work. — Here, again, it would be prejudicial 
to make a distinction between boys and girls, on prin- 
ciple. Household managers and cooks (chefs) are just 
as often males as females, speaking vocationally. 

First take the children all over the house and give 
them a systematic idea of what a house and a household 
is, and what a household requires. To many this will 
be a revelation. 

The different departments of housekeeping: Cleaning, 
cooking, marketing, laundry, care of linen, mending, etc. 
Household accounts are fitly connected with arithmetic. 
(Model storekeeping.) 

Then begin with an imaginary empty house; or take 
them to a newly built unfurnished house, perhaps one 
of their own building. 

Assign the different functions to the different rooms: 



SCHOOLS FOR ATYPICAL CHILDREN 523 

Living-room, reception-room, library, bedrooms, bath 
and toilet, kitchen, pantry, laundry, cellar, boiler-room, 
garret, etc. Discuss the different sets of furnishings for 
these rooms so that they may serve their respective func- 
tions. Make scrap-books of furniture pictures (from 
magazine and other advertisements) and arrange the 
pictures by rooms. Add wall and floor coverings, pic- 
tures, curtains, etc. Excursions to furniture stores and 
factories. 

Bring out the idea of suitableness of furnishings for 
these rooms, and the beauty and fitness of each piece. 
Practical and impractical furnishings. Harmonious and 
inharmonious effects. Water-supply, heat-supply, plants 
serving these purposes, fuel, stoves, furnaces, fireplaces, 
chimneys. Old methods of house appointments. (Cf. 
"Home Life in Colonial Days," by Alice Morse Earle.) 

Different Types of Houses. — Huts, log houses, cot- 
tages, bungalows, farmhouses, city houses, one and two 
family houses, apartment and flat houses, hotels, institu- 
tions, public buildings, churches. Primitive dwellings. 
Houses in foreign lands. Streets, squares, city systems. 
Country houses and grounds surrounding them. Build- 
ing material: wood, stone, brick, concrete; where to be 
obtained, how made, how transported. Connection with 
shop-work. 

Keeping the House in Order. — Cleaning, sweeping, 
washing of floors, scrubbing, dusting, cleaning win- 
dows, etc. 

Give idea of work involved, amount of it, time and 
energy it takes. Have each pupil clean one room, giv- 
ing as many activities as possible; then count the num- 
ber of rooms cleaned to find the time needed for the 
entire operation. Eventually repair-work in connection 



524 THE EXCEPTIONAL CHILD 

with shop — painting, tightening screws, resetting win- 
dow-panes, and the like. Have each child take care of 
his or her own room, making the bed, keeping washing 
materials (bowls, pitchers) in order, keeping tab of soap, 
towels; hanging pictures, curtains. 

Laundry. — Collecting wash, soiled and clean. Folding 
it up properly and putting it away. The beauty of 
order: "A place for everything and everything in its 
place." Practice in washing, mangling, and ironing, 
also in mending. Dolls' clothes; their own clothes. 

Kitchen. — Care of stove and dishes. What consti- 
tutes a set of dishes. Kitchen outfit in detail. Menus. 
Marketing. Cost of meals, economy. Using left-over 
materials in new form so as to avoid waste. Variety of 
menus, also for different seasons. Reason of mixed diet. 
Sources of supply (connect with geography and nature). 
To the maturer pupils some idea may be given of the 
chemistry of food and digestion; simple dietary and 
physiological instruction may be given even to younger 
children. 

Have children observe how meals are prepared and 
have them help in getting things ready : peeling potatoes, 
trimming vegetables, etc. As an introduction to sys- 
tematic lessons in cookery which are given to the older 
pupils, the younger ones may learn to make simple sal- 
ads, toast, to prepare cereals, boil potatoes, water, eggs, 
tea; skim milk, serve milk, make butter. They may fill 
the sugar-bowls, salt and pepper cellars, etc. Later they 
will learn to make simple dishes and to prepare simple 
meals, also serving special meals on trays. In the dining- 
hall they should learn how to set a table, how to take 
care of table-linen, how to wait on the table, how to 
clear tables and to care for cutlery, dishes, glasses. 



SCHOOLS FOR ATYPICAL CHILDREN 525 

Camping-time will serve to emphasize the lessons of 
a simple life. 

Nature Study. 1 — It is unnecessary here to elaborate a 
course in nature study. Only the following remarks 
may be inserted: 

While some time is allowed for regular periods, with 
experiments of all kinds in the classrooms, including, 
botany, zoology, biology, physics (models of machinery, 
engines, motors, pumps, etc.), and chemistry, much 
of the work is done outside of these periods. These 
periods can be used to advantage to crystallize and re- 
view what has been taken up while the children went on 
walks and excursions. 

The children should learn to know the world about 
them in all its phases, at least through typical examples. 
Collections of plants, flowers, leaves, nuts, seeds of all 
kinds, stones and minerals, soils, etc., should be made in 
abundance. (Correlated with art-work.) The habitat 
of each specimen should be carefully studied. Butter- 
flies, insects, birds, domestic and wild animals, etc., 
should receive attention. Pet animals. Aquaria. Ter- 
raria. The grounds about the school can be converted 
into a sort of botanical garden, all trees, shrubs, vines, 
vegetable patches, etc., being labelled. 

Little time should be spent in artificial classifications 
and cumbersome minutiae. 

The older groups are to be organized into regular 
working-squads to systematically cultivate the garden 
on a large scale, care for the orchard, grape-vines, ber- 
ries, and the like; in short, they are to learn real truck- 
gardening and simple farming. They are expected to 

1 "The Career of the Child," chap. XI, "Nature Work as an Objective 
Basis." 



526 THE EXCEPTIONAL CHILD 

clean up the grounds, mow the grass, make hay, trim 
trees, cut out underbrush, collect and cut up wood for 
winter use, clean horses, take care of them and hitch 
them up, clean and oil wagons and harness, learn to milk 
cows and do dairy-work, etc. 

Study of Geography. 1 — Make the work strictly objec- 
tive. Connect with walks, excursions, and games. 
Stress to be laid upon having the pupils study geographi- 
cal features experimentally and by direct observation. 
After the excursion the class lesson should be given to 
review and organization. This will lead to generaliza- 
tions and to application to more distant localities. The 
study should include discussion of the various land for- 
mations, crops, industries, population, government, lo- 
cation with reference either to adjoining townships, 
counties, or States. Imaginary journeys. 

The pupils reproduce land formations on the sand-ta- 
ble or preferably on a larger scale on the school-grounds, 
learning to utilize power and energy, such as water, 
wind, etc. Reproductions of geographical features may 
also be made in papier-mache (paper-pulp), clay, or 
putty, with natural rocks, moss, bridges, etc., on a large 
table which may be used for the illustration of entire 
landscapes (cf. "History"). Mechanical railway sys- 
tems (electric toys). The composition of various soils 
and rocks, and their geographical significance may be 
studied by the older children, in conjunction with 
nature-work. 

The motions of earth, moon, sun, stars, constellations, 
must be observed by actual study of existing phases. 
Records of weather conditions can be systematically 

lu The Career of the Child," chap. IX, "Geography as a Collective 
Centre." 



SCHOOLS FOR ATYPICAL CHILDREN 527 

kept. Rough maps of excursion scenery, the grounds, 
the neighborhood, should be frequently made. 

History Study. 1 — The work should never be dependent 
upon a text-book. It must be done by oral presenta- 
tion, study of causes and sources, ever so elementary, 
and a proper development of the subject-matter through 
discussion and story. The text-book serves as a refer- 
ence book and reader mainly, perhaps as a guide to the 
teacher. Emphasis must be laid upon the historical and 
geographical setting of events. The biographical and 
generally human element must preponderate. This may 
be made as objective as possible by introducing suitable 
historical books and novels as references; pieces of poetry 
(also contemporaneous) , illustrative games, collections of 
various kinds (school museum), excursions to historical 
places and to museums, indoor and outdoor dramatic 
representations, sand-table illustrations, constructions in 
wood and other material (connect with manual training 
and geography), the use of "modelling sheets" and 
other cardboard-work, illustrating houses, mills, castles, 
etc., dressing dolls in the costumes of various lands, 
climes, and times, etc. 

Number, Space, and Form. 2 — In number the work 
with younger children is almost exclusively oral, the 
text-book being seldom in the hands of the children. 
The development of the concept of number as precise 
quantity is the object to be striven for. A child must 
realize that the conception of quantity is different from 
counting. Following the lead of primitive methods of 

'"The Career of the Child," chap. X, "History as a Collective 
Centre." 

2 "The Career of the Child," chap. VIII, "The Mathematical Evolu- 
tion of the Child." 



528 THE EXCEPTIONAL CHILD 

counting and computing, introduce knotted cords and 
beads, notched sticks, and the counting-frame (abacus) 
of the toy store and the Chinese. As early number- 
concepts are usually space-concepts, the geometrical 
method should be carried through all the lower groups. 
Lines and distances, surfaces, desk tops, windows, doors, 
rooms, carpet lengths, corridors, porches, roads, garden- 
beds, and whatever offers an opportunity for such work 
should be measured. Recognition of larger units, like 
yards and feet, are developed first; gradually smaller 
units may be added ; finally, fractional parts. The young 
child should be taught to verify his number-concepts in 
problems, thereby also beginning to grasp concretely the 
important steps of mathematical processes. All mechan- 
ical processes, such as division, subtraction, multiplica- 
tion, addition, fractional parts, must first be taught as 
concrete problems and be made abstract or automatic 
only after the true meaning of the process itself is clearly 
grasped. When difficulties arise in the presentation of 
new matter (as in the introduction of fractions) the 
cause should be ascertained. This cause may not always 
be found in the method employed, but often in the 
mental unpreparedness of the pupil. Fractions, e. g., 
are usually introduced too early, before the child's mind 
is ready to handle them. 

With a development of right concepts and mechanical 
facility the child begins to visualize. The individual 
power of ready visualization is in a measure a native 
gift, and has much to do with success in mastering the 
mechanical processes. Connected with a definite con- 
crete experience begins the estimating of lengths, dis- 
tances, areas. To check up and reconstruct the gradu- 
ally forming precise concepts, frequent practice in veri- 



SCHOOLS FOR ATYPICAL CHILDREN 529 

fication and re-estimation is of value. All children 
should be taught to tell time, using the watch, the posi- 
tion of the sun, the sun-dial, as guides; the days of the 
week; the months; computing dates in the past and 
future; manipulating money and change, also buying 
and selling in definite values, using a "Model Store Out- 
fit," 1 or similar contrivances. 

The puzzle interest can be introduced to great ad- 
vantage, suiting the complexity of the puzzle to the type 
and maturity of the child. 

Much exercise can be given in card, lotto, and domino 
games, number-cards, etc. Whenever possible, number- 
work should be connected with concepts in manual ac- 
tivity, nature-work, history, geography, etc. The nu- 
merical aspect leads to "precise cognition" of values. 

All signs and operations should be simplified inde- 
pendently of the text-books. No distinction should be 
made between "long" and "short" division. All prob- 
lems must be based on the idea of equation, and alge- 
braic methods can be introduced at an early stage. 

The study of form, area, space, etc., through geometric 
puzzles (anchor puzzle), geometric construction and de- 
sign (in co-ordination with manual and art work) will 
not only be a study in itself, but offer methodical sug- 
gestion for the presentation of arithmetical problems. 

Language Teaching. 2 — The purpose of this subject is 
not to impart knowledge of grammar as a logical science 
or mechanical information. It is to educate the child 
in the use of good English, orally and in writing. Em- 

1 Cf. "Model Store-Keeping Department" of the "Educational 
Foundations," New York. 

2 "The Career of the Child," chap. XII, "Language Teaching from a 
Child Study Point of View." 



530 THE EXCEPTIONAL CHILD 

phasis upon the formal side of this subject should be 
laid only in so far as it is necessary to secure correct 
speech and enunciation, composition-writing, clearness 
of spoken and written language, correct spelling, and 
the division of words into their phonetic elements when- 
ever advisable. In every case the child's vocabulary 
should be enlarged. This does not mean that mere 
words should be added, but that more concepts be devel- 
oped in connection with the work in every branch of 
instruction. The language-work must be utilized to work 
over these concepts and make them clear-cut through label- 
ling them with their proper names, and link them, through 
language expression, with previous concepts. These 
names, by way of conversation, constructing definite 
statements, debates, and compositions, are systemati- 
cally added to the vocabulary. 

Care must be taken in all this work not to super- 
impose the teacher's more or less conventionalized mode 
of expression. The child's own methods of self-expres- 
sion can be respected, and discreetly developed, even 
though they would strike the teacher as crude and un- 
conventional in the beginning. The pupils should con- 
vert their compositions into dramatic and conversational 
forms, eventually to such a degree that groups may pre- 
sent their work to other groups in school exercises. 

Spelling and language puzzles can be used systemati- 
cally to great advantage. Pupils may invent similar 
puzzles, from the samples given, of their own initiative. 

Children must learn to take notes on their walks, ex- 
cursions, during the lessons, etc., and proper methods of 
taking such notes and of expanding them into a more 
complete reproduction of their experiences must be sys- 
tematically taught. 





BBBBSfr^ MBReki 

■k ^MBjprf™ mHL' Jm$* • \ 
wfm ' "^^SKaBP^^HBk. ■ ^wf> -I 

w^ aft' 1 

&__ ■ 4 I^^jIbbBbI I <*. 

BBBBB A 1 
^H ^^1 ^H 





Fig. 46. — Dramatics: Scene from "The Sleeping Beauty. 




Fig. 47. — Dramatics: Dance of the ice-bears, 
to Northern Lands." 



From "A Dream-Trip 



SCHOOLS FOR ATYPICAL CHILDREN 531 

Formal exercises are secondary. Insistence upon cor- 
rect speech is mandatory in all lessons, but care must be 
taken not to make this insistence irksome to the pupils. 
Too much pedantry will repress the desire of the child 
to express himself freely, and it is better to leave crude and 
incorrect forms of speech unchallenged than to silence the 
child. 

Oral and written composition 1 and letter-writing, by 
dictation and blackboard development, by the class and 
by individuals; the evolution of tabulations, schedules, 
paradigms, synopses, etc., for the organizing of the ma- 
terial studied, so that the mind of the pupils would ar- 
range it in proper order, must be constantly emphasized 
in all lessons. Dictated work may be typewritten or 
printed 2 and used as reading-matter for the dictator and 
his group. 

Reading and Literature. 3 — While it is necessary to cul- 
tivate loud reading for the training in proper enuncia- 
tion, elocution, and modulation, and for the purpose of 
checking up the child's progress and precision, it must 
never be forgotten that reading aloud is a separate motor 
activity, and that the main purpose of learning how to 
read is to train the pupil in the ability to abstract informa- 
tion from the printed or written page, and to teach him 
how to find this information. Too much forcing of oral 
reading to teacher and class may tempt a timid or 
nervous child to stutter. 

Silent reading, with subsequent reporting on what has 
been read, is therefore very important. The ability to 

^'The Career of the Child," chap. XIV, "Oral and Written Com- 
position." 

2 The introduction of typesetting and the printing-press is a valuable 
addition to the occupational work. 

3 "The Career of the Child," chap. XIII, "Reading and Literature." 



532 THE EXCEPTIONAL CHILD 

absorb the sense of a sentence, of a paragraph, and, in the 
higher groups, of a chapter, or a whole book, after rapid 
perusal, must be carefully developed. Pupils must ac- 
quire a sufficient vocabulary, and the skill of finding un- 
known words in the dictionary. 

Quick recognition of words and their analysis as to 
component parts, so that the reading and understanding 
of words may be facilitated, must be carefully taught. 
The derivation and composition of words will therefore 
be a helpful method in teaching spelling. Pupils are 
of two different types, visual and aural; each type re- 
quires a method of learning and spelling words commen- 
surate to its apperceptive faculty. 

Spelling has the purpose to help in the formation of the 
word-form concept, and to enable a person to write a word 
correctly, so that the reader may recognize it. Copying 
and writing certain words frequently in proper sentence 
setting will do more than mere oral drill. It is a com- 
mon observation that pupils, in learning a foreign lan- 
guage, have little difficulty in mastering the spelling of 
the foreign words. This gives a most helpful suggestion 
in the matter of teaching English spelling. 



CHAPTER XXVI 

THE TRAINING OF TEACHERS 1 

The Teacher as an Essential Factor. — Inasmuch as 
the teaching of exceptional, "different," non-conforming, 
difficult children does not require any patent methods, 
but simply the application of rational methods to indi- 
vidual conditions, it may be said that special training 
for the teacher of non-conforming children is unneces- 
sary. This is not quite true. Of course, every teacher 
should be so thoroughly trained that adjustment to dif- 
ferent child types would be ingrained in his or her prac- 
tice. The special difficulties of exceptional develop- 
ment in children, however, make it desirable that a 
selection should be made. There are also differences of 
type among the teachers, and some are better fitted to 
undertake finely discriminating work than others; some 
have the artist-teacher spirit, that deeper insight into 
child nature which puts them in almost immediate rap- 
port with their pupils. But even the artist needs special 
training. 

In many places in this book the teacher has been 
pointed out as the essential factor in approaching and 
appreciating differences in children. Were our teachers 
generally better trained in understanding child nature, 
there would be less failure in educational efforts. 

"'The Career of the Child," chap. I, "Dignity and Responsibility 
of the Teacher's Profession." 

533 



534 THE EXCEPTIONAL CHILD 

The Teacher's Function. — The popular idea that 
teaching means merely the imparting of knowledge is 
very superficial, of course. True teaching means pre- 
paring a child to understand the world in terms of his 
own experience; placing him and his conduct in harmony 
with a social body, so that he may become a constructive 
factor in community life and avail himself of the op- 
portunities for right living which are offered to him 
by his fellow men. 

Teaching refers, therefore, not so much to "what" a 
child can be made to learn. It means to train him 
"how" to attack a problem placed before him. Merely 
to learn certain facts about arithmetic or history, de- 
pending largely upon memory for retaining this "knowl- 
edge," will prove very unreliable, and will rarely fit the 
child for the demands of life. Even a mentally defective 
child — an abnormal child — can be "taught" in this 
manner without gaining thereby in human efficiency. 

Meaning of Education. — Education, to be vital, means 
that a child must learn: 

First. — To absorb and interpret every-day experiences. 

Second. — To organize daily experiences so that they 
may constitute a new apperceptive basis for further 
progress. 

Third. — To realize and appreciate the relation of cause 
and effect. 

Fourth. — To develop a mental perspective in which 
new situations .may be foreshadowed to be met with 
ready preparedness. 

Fifth. — To select the right course of action in meeting 
real or imagined situations. 

Sixth. — To control his acts by a properly poised atti- 
tude. 



THE TRAINING OF TEACHERS 535 

Seventh. — To understand his relations to others and 
the reaction of his conduct upon them and their welfare. 

These are some of the essential considerations to be 
borne in mind in planning the education of a child. To 
give such an education the teacher, assuming a function 
supplementary to the parental function, must be pre- 
pared. 

The Child's Point of View. — To teach a child success- 
fully "how" to learn implies that the teacher must first 
of all appreciate the child's point of view and his state 
of mind. Unless he can put himself in the child's place 
he will fail to understand his mental horizon. It will 
depend upon the child's mental vision what daily experi- 
ences he will absorb and how he will interpret them. 
The teacher must know, as far as possible, the child's 
apperceptive basis, his way of " taking in" a new experi- 
ence, how he will connect the new with the old, so as to 
have an orderly knowledge. Cause and effect, especially 
with new experiences, are matters of the individual 
point of view. The young child does not learn things 
on the basis of logical order — to him nothing is definitely 
impossible or irrational; he learns from isolated experi- 
ences which he relates to each other in his own way. 
This question of relationship may be quite fortuitous in 
registering the experience-units in the child's mind. 
Hence the frequently twisted connections, the gross mis- 
understandings, often distinctly ludicrous from the 
adult's point of view, which crop out in a child's re- 
sponses. They show the accidental combination of ex- 
periences which were registered in the child's mind at 
some time and which became connected in his thoughts 
through propinquity rather than through rational rela- 
tion. Here the wise guidance of the true teacher is 



536 THE EXCEPTIONAL CHILD 

needed, so that the idea of cause and effect may come 
to the child on a basis of correct association of ideas. 

Qualitative Differences of Subjects. — Further, the 
teacher must realize that the different branches of in- 
struction, as differentiated in the ordinary school courses, 
offer distinct and inherent qualitative problems in pres- 
entation. For this reason each will appeal differently 
to a child, so that he may be more ready to learn his- 
tory than arithmetic, or vice versa. Again, apart from 
their inherent qualitative differences, the subjects may 
be taught by various methods. That the child may size 
up the situation, that he may array before his mental 
vision possible new situations from which he may find 
guidance for his further course — very different mental 
processes may be called into play when studying one 
subject than when studying another. Suppose a teacher, 
in teaching mathematics, would use merely mechanical, 
abstract drill and an appeal to memory ; the pupil's prog- 
ress may be completely blocked because the situations 
presented do not project themselves into his rational 
consciousness, do not articulate themselves with his 
apperceptive powers. Thus he will fail in arithmetic. 
On the other hand, nature study, lending itself more 
readily to concrete presentation, may appeal immediately 
to the child's interest, to his apperceptive powers, to his 
ability and desire to compare and to differentiate — and 
will thus promptly open up a wealth of associations, 
broadening the pupil's field of vision, relating facts with 
facts and thus allowing the child to employ facts as 
measures of new situations. 

Native Differences of Individuals. — A recognition of 
these conditions will lead the open-minded teacher to 
the appreciation of the further fact that there are essen- 



THE TRAINING OF TEACHERS 537 

tial differences between individual pupils; that the emo- 
tional quality as well as the mental type of one child 
may vary considerably from that of another. The emo- 
tional quality alone is of tremendous moment in the de- 
velopment of the individual psyche. This very emotional 
vitalization of neutral external phenomena, mediated to 
the perception by the senses, is the essential force in 
our minds which colors our motives, shapes the relation- 
ship of our ideas, ideals, and deeds, and is the chief fac- 
tor in our interpretation of life. 

These differences of emotional attitude and of mental 
type — the latter being in a measure the result of the 
emotional attitude combined with the result of uneven- 
ness of growth of the mental faculties — cause one child 
to make rapid progress in a subject in which another 
will lag behind. They present perplexing problems to 
the teacher. When these differences in progress assume 
large proportions, we recognize what we have learned to 
call unusual or exceptional children. 

It is evident that one of the first requirements in the 
preparation of teachers for their work is that they be 
trained in recognizing and valuing correctly these dif- 
ferences. Mere than his ability to master the intricacies 
of a subject, or of a number of subjects, counts a teacher's 
ability to master the child problem, the intricacies of a child 
soul. When the teachers will have learned to assume 
the right attitude toward this fundamental problem, 
there will be a surprising shrinkage in that group of 
school failures now stigmatized as "subnormal," "de- 
fective," "delinquent," "incorrigible," or "backward" 
children. We shall then learn that very many of these 
troublesome children are not lacking in possibilities — 
that it is not their fault that they fail, but the school's 



538 THE EXCEPTIONAL CHILD 

which fails to reach them. After all, to solve these indi- 
vidual riddjes, using the word "solve" in its broadest 
sense, is the true mission of the teacher. 

Specialization in Teaching. — We are breaking away 
from the older, ungraded method of having one teacher 
teach all subjects. With the centralization of schools, 
produced on the one hand by the increased concentra- 
tion of the urban population, and on the other by the 
merging of rural schools into district centres, there is a 
constantly increasing tendency on the part of teachers 
to select special branches of instruction, or at least spe- 
cial fields of application. We have the primary, gram- 
mar, and high school teachers; the teachers who confine 
themselves to some one or to a small group of related 
subjects; the teachers of music, of art, of manual train- 
ing, of domestic work, etc. 

This specialization has its drawbacks. It tends to 
narrow dow,n the mental outlook of the student who 
specializes too early. The broad view of the educational 
problem must be the foundation. It may be suggested 
that specialization of a pronounced kind should be the 
second step in teacher training. This, however, might 
invite the pernicious practice, still so common, that the 
tyro teachers are let loose upon the tyro children, those 
precious blossoms of humanity which just open their 
petals to the sun of knowledge. Primary teaching is 
really a very delicate problem, worthy of the most careful 
specialized preparation. 

It will at once become evident that much of the gen- 
eral subject-matter now included in teacher training will 
become extraneous under more intensive preparation. 
While this intensive preparation acts in a measure as a 
restriction of individual activity, it offers at the same 



THE TRAINING OF TEACHERS 539 

time a wider field for selection and better training, com- 
mensurate to the special talents and abilities of the indi- 
vidual teachers. For, naturally, each teacher is also an 
individual personality, and represents a mental type 
different from the "average" — if he is a teacher at all. 

Review of a Suitable Curriculum. — The curriculum of 
a teachers' training course should include, it would seem, 
the following main divisions: 

First: A comprehensive presentation of a classifica- 
tion of the various types of children, with their more or 
less pronounced variations. With these types the stu- 
dents must be confronted face to face. They must 
learn about the various physical and mental tests used 
to diagnose types. They must learn to read danger- 
signals. They should, however, from the start learn to 
understand their limitations in this field, and that they 
will have to co-ordinate their future work with experts 
in the field of medicine, psychology, and scientific peda- 
gogy. After all, the rank and file of teachers cannot 
all be experts and leaders; they must understand pro- 
fessional discipline and modesty, without ever giving 
up the striving for higher perfection. 

This presupposes the demand that teaching must be- 
come a true profession. 

The study here outlined would eventually enable the 
student to recognize what type of children he could best 
train, to what type he could most forcibly appeal — 
whether his heart leads him to let little children come 
to him that he may guide them along the road of 
knowledge and mind-power, or whether he would wish 
to struggle with the problem of adolescence ; whether it 
is the manual, the graphic, the artistic, the scientific, 
the scholastic mind, or whichever else that most ap- 



540 THE EXCEPTIONAL CHILD 

peals to his instincts. He will naturally select the type 
most akin to his own. Should he choose to specialize 
with the unusual child, varying to a marked degree from 
ordinary types, he would have a clear survey of the 
field, its scope, his own fitness, what he would have to 
study, etc. So he may map out his studies to insure 
real efficiency. 

Second: The teaching of methods will have to be 
essentially revised. Only too often the young teacher 
leaves the normal school permeated with methods of all 
kinds and just brimming over with the desire to try them 
out in his own way on the pupils given over to his care. 
Only too often the result is disastrous. Why? 

" Method," as generally conceived, is related to the 
subject-matter primarily, not to the individual psyche 
of the child. It is more or less theoretically defended on 
general grounds. Thus, in learning to read and to spell, 
children have been subjected to the "word method," 
the "alphabetic method," the "phonetic method," the 
"phonogram method," and a host of others. One 
teacher recommends the one as the only salvation of 
the child, another is enthusiastic over another. In re- 
ality the success depends upon the response of the child, 
which in its turn depends upon the type of child mind 
appealed to. It is a matter of selecting the proper 
method, not only for a particular group of children, but 
for individuals within the group. In the same class 
several different methods may have to be used along- 
side of each other, or superseding one another, to reach 
out to all. 

Again, a method depends for success much upon the 
person who employs it. It is to a considerable degree 
the expression of the teacher's own personality. One 



THE TRAINING OF TEACHERS 541 

teacher may make a certain method work with almost 
any class of children, when another will fail utterly. 
Young teachers make the mistake of following the lead 
of their normal school teachers too slavishly. They 
must first learn what they themselves can do with a 
method, how they can project themselves into the souls 
of their pupils. The personal equation plays an im- 
portant part. 

"Methods" can only serve as a working basis in 
training a child, a sort of reserve fund from which to 
draw from time to time to meet new situations. 

Third: The subject of educational psychology needs 
revision to be of value to the practical teacher. As it is 
taught in our training schools it hardly helps the teacher 
materially in his professional work. A great deal is in- 
cluded because sanctioned by tradition, or is retained in 
the curriculum because of a general idea that it has, or 
ought to have, a general value in one way or another for 
the teacher. Just what this value is has not been 
accurately ascertained by psychological analysis. While 
other subjects have been thus analyzed, psychology it- 
self has not applied its own method to itself. Hence, the 
whole subject is encumbered by a mass of material lack- 
ing in direct bearing on classroom experience; it is pre- 
sented without a clear conception of the relation of edu- 
cational psychology as a subject, to psychology as an 
important phase of educational principles. To illus- 
trate: Knowing what mental imagery is and how it 
develops is one thing; recognizing mental imagery as it 
unfolds in an actual child's mind, understanding that 
child's personality, and then applying psychologically 
the best methods to develop that imagery rationally is 
an entirely different thing. 



542 THE EXCEPTIONAL CHILD 

Educational psychology must be so taught that it 
drives home to the teacher the need and method to find 
the child's point of view, to experience the child's state 
of mind. It must lead to an understanding of the psy- 
chologic significance of the different school subjects, 
and of the causes of their differences; and also to an 
understanding of the causes of differences of individual 
minds. Of course psychology cannot be taught from 
text-books alone. It must be vitalized by taking the 
student right into the labyrinth of practical child prob- 
lems, not only in the schools but in the homes, the 
streets, the courts, etc. 

Fourth: The student teachers should therefore be 
given ample opportunity of practical experience with 
children. Not only in the schoolroom, with "practice 
teaching," but as school visitors, social workers, in the 
larger life of the community. Before a teacher under- 
takes to "teach" a child he should understand the souls 
and conditions of children, he should study the many 
pathetic problems of child life. And let him not deceive 
himself that this pathos is to be found only among the 
lowly and the outcast; it casts a shadow over many a 
child of the wealthy and mighty. There are sad child 
faces, wicked child faces, debauched child faces in the 
palaces as in the hovels. 

Compared with the problems of this practical child 
psychology, the problems of subjects and methods will 
seem almost insignificant. 

Fifth: The student should receive a broad training 
in physiology and hygiene. Even the ordinary class 
teacher should be able to recognize patent physical and 
psychic disorders, so that he may co-operate intelli- 
gently with the school nurses, medical inspectors, and 



THE TRAINING OF TEACHERS 543 

specialists of different kinds. A knowledge of physical 
and mental hygiene and the elements of medicine would 
also help him to realize the effect of his teaching upon 
the physical and mental life of the pupils. Only too 
frequently there is an artificial production of exceptional 
development going on right under the teacher's eyes, 
caused by him, yet entirely unobserved and ununder- 
stood by him. The teacher must learn to assume the 
"medical attitude" in looking for causes and in the 
endeavor to diagnose. 

These are some of the main points where teacher train- 
ing needs to be lifted out of tradition upon a new and 
higher plane of efficiency. It goes without saying that 
there must be a course in the history of education, as a 
history of human ideals; a careful training in the sub- 
ject-matter of knowledge and occupations, etc. 

Training of Teachers for Exceptional Children. — To 
specialize in the education of exceptional children is a 
delicate problem. Of course, there are again many sub- 
divisions of this training. These subdivisions have so 
far been as little recognized as have been the divisions 
of the exceptional children themselves. The term has 
been, as was shown before, indiscriminately applied to 
"defective" children, with a great confusion of terms, 
employing such words as "subnormal," "abnormal," 
"backward," and a host of others interchangeably and 
vaguely. 

The teacher of the blind needs a special training differ- 
ent from the kind the teacher of the deaf requires. The 
atypical child is a very different problem from the child 
of arrested development, or the feeble-minded child. 
The retarded child needs different treatment from the 
child who is exceptionally bright. The psychopathic 



544 THE EXCEPTIONAL CHILD 

child must be placed under a regimen which would be 
entirely out of place for the dull and unresponsive. 

It is clear, then, that teachers' training courses must 
be adapted to these various needs; and that again the 
personality of the teachers themselves, differing in tem- 
perament and attitudes, must be determinative in the 
choice of the special field of work. 

Many of the courses offered in universities, colleges, 
and similar institutions in recent years for the training 
of special teachers of this kind have been undifferentiated 
and lacking in perspective. The only courses which 
deserve to be called specific are those which have been 
given in several of the institutions for the feeble-minded. 
Yet even these have suffered from two grave errors — 
one being that they were too short to afford thorough- 
going training; the other that they were advertised and 
utilized for the training of teachers of ungraded classes 
and of "experts" in testing children, when in the very 
nature of their organization they could be nothing more 
than courses for acquainting teachers with the problem 
of the feeble-minded. 



CHAPTER XXVII 
CONCLUSION 

This book has covered a large field. Naturally it 
cannot be expected that it has treated every detail ex- 
haustively. But the author hopes that he has stated 
the problem in its completeness, and that he has given 
its perspective clearly and unmistakably. 

In the first part the author attempted to state the 
nature of the problem, and to portray, somewhat in 
detail, the different kinds of the human material which 
makes up this civilization of ours. It must have become 
evident to the careful reader that the problem of the 
exceptional child, as here presented, is really a problem 
of civilization itself — that it goes to the very root of the 
tree of human life; that upon its solution depends the 
progress, yea the very existence of the race. If it is not 
solved in a sane and constructive manner our present 
civilization will be swept away as other civilizations have 
perished in the past, to give way to new, raw attempts, 
by untried races, to build up a better human society than 
there was before. The dreams of perfection, of salva- 
tion, of the millennium, such as are in the minds of our 
religious enthusiasts and philosophers, may never come 
true. Yet, if there is to be at any time "a new heaven 
and a new earth, when all men will speak a pure 
language, and no one will hurt another any more, and 
no one will wrong another any more," we certainly 
must first give full opportunity for each individual to 

545 



546 THE EXCEPTIONAL CHILD 

be himself, to live up to the potentials which God has 
planted in his soul, so that he can be true to himself. 

"To thine own self be true, 
And it must follow, as the night the day, 
Thou canst not then be false to any man." 

In other words, more practically speaking, we must 
recognize and cherish variations of the human type, 
acknowledging in them the very safeguards and guaran- 
tees of progress and higher culture. 

The second part discusses and describes methods of 
diagnosis. In detail the suggestions made by the author 
in this part may be open to criticism and revision. Of 
the need of further correction of details, of rearticulation 
of parts, of greater precision and condensation, or, on the 
other hand, of expansion, no one is more fully convinced 
than the author himself. This need impresses itself 
upon him with every new application of his own method 
of testing. But every new application strengthens his 
conviction that the principles upon which he bases his 
suggestions are essentially correct. It can only be 
through the co-operation of many workers in this field, 
through intelligent and harmonious collaboration of experi- 
ences, through willingness to share and exchange in fair 
measure the success which every individual effort may 
achieve, that a final form will be created, out of the multi- 
fariousness of forms now offered for experiment. 

The third part is intended to elucidate the bearing 
these facts have upon active constructive work for the 
betterment of the race. We discussed eugenic problems 
and problems of the home; questions of school reorgani- 
zation and social adjustment. It was discovered that 
the old adage, "Mens sana in corpore sano," had as- 



CONCLUSION 547 

sumed a new significance, and that the problems under 
discussion were in a large measure medical problems, 
problems of mental health through physical health. 

The author's demand that there must be adjustment 
to individual types and interests must not be miscon- 
strued. This demand is far from placing the child at 
the mercy of passing impulses and passions, fashions 
and whims. It does not imply a "cult of flabbiness" 
as the mistaken yielding to the line of the least resist- 
ance has recently been called. Quite the contrary. The 
healthy instincts of the child are not flabby. They are 
impulses for strenuous action. As soon as the baby 
feels the strength of his muscles and nerves, he wants to 
exercise his young limbs to the utmost; he wants to sit 
up, to stand up, to walk, even when his timid mother is 
yet afraid of trusting the weight of her precious to his 
little feet. The author knows a very little boy who has 
never wanted to walk on the easy path. He, living on 
a mountain top, has ever since he began to walk selected 
the roughest places to climb up, the rockiest trails to 
exercise his little legs and his sense of balance, and has 
forever spurned assistance, unless it was absolutely 
needed. And in all other pursuits he does likewise, al- 
ways looking for difficulties to overcome, always exer- 
cising his patience as well as his skill to master a task 
which he has set before himself. 

A child who is lazy, who looks for the easy things of 
life, is either spoiled by misdirected education, or a sub- 
ject of medical and psychopathic examination. 

The author is thoroughly imbued with the spirit of 
Kantian philosophy, in its educational aspect. Kant, 
the sage of Konigsberg, pronounced the "categorical 
imperative," meaning duty as the supreme rule of life, 



548 THE EXCEPTIONAL CHILD 

as the pivotal point around which life's activities must 
revolve. The joy of hard work, of self-sacrifice, of the 
devotion of the individual to unremitting service in the 
interest of the commonwealth, is characteristic of this 
idea. It is a modern form of Stoic philosophy, or, if 
you will, of Spartan ideals of efficiency. 

He would therefore be the last one to advocate the 
cultivation of effeminate and self-gratifying habits in 
the young. But he is likewise convinced that only that 
individual will make his best efforts for service who can 
be himself — who is allowed to follow the lead of his 
natural genius. 



APPENDICES 



APPENDIX I 

THE CITY AND HER BOYS 1 

Classification. — For the purpose of discussing the city and 
her boys let us make a broad classification. It has been esti- 
mated that there are 500,000 boys in New York between the 
ages of seven and sixteen, and these boys may be roughly classi- 
fied for our purposes into the following groups: 

(1) The boys of wealth; 

(2) The boys of the middle class, with full-functioning homes; 

(3) The boys of the semi-functioning homes; 

(4) The homeless boys. 

The first group contains those boys who are amply protected 
by families of established reputation. The second group is the 
largest, that of boys who are fairly well-to-do, whose fathers 
work while the mothers care for the home. The boys of this 
class usually enter high school and secure their recreation 
through the Y. M. C. A., Scout movements, and similar organiza- 
tions. This group is well provided with recreation as compared 
with Groups 3 and 4. The third group contains those boys 
that may have to work to help support the home. The mother 
frequently is required to work outside of the home, thus leaving 
the boy to the street. It is this group that furnishes the majority 
of delinquents and truants. The boys from this group live pri- 
marily in the congested districts where parental control is in- 
sufficient. The fourth group are the boys without a home, the 
occupants of our lodging-houses and institutions. A great 
many boys in this group are transients. 

This classification is as inaccurate as any classification of 
human beings. 

1 This section has been contributed by Mr. Albert B. Hines, Director of 
Madison Square Boys' Club; Member of Bureau of Municipal Research as- 
signed to social work in connection with wayward boys. 

549 



550 APPENDIX 

The City's Duty Toward the Boy Problem. — What is the duty 
of the official city as constituted by the State to the boy prob- 
lem? The value of the city lies not in her property, her courts, 
her railroad facilities, her location, but in her citizens. The 
city has her department for the protection of health, public 
safety, fire, parks, courts, and so on. Why should she not have 
a department for the protection of her children? It might be 
called a Child Welfare Department, and its duties would be to 
see that all the available facilities possessed by the city for 
children's work should be used to their highest efficiency. 
When we realize that at the present time only 5 per cent of the 
boys are given suitable recreation, and when we further under- 
stand what John Collier has said: "Juvenile crime is a play 
problem — not only in the sense that play is an alternative to 
crime, a cure for crime; but in a more specific sense, namely: 
in the streets of New York under present conditions play is 
crime and crime is play " — we shall approach the solution of 
the problem intelligently. 

There are streets, open places, parks, buildings, various city 
departments, recreation centres, pools, libraries, and many 
other city-owned properties that might be put to use in the in- 
terest of the children. The cost, of such a bureau as suggested 
would soon be returned to the city. The boy problem is a city 
problem; the city's wealth consists in her human assets, and it is 
within the city's power, since she has the means to make this 
human asset what she will. The city has shown the parental 
attitude when the child has broken her law — why should she 
not go further and show this parental attitude to the child for 
the purpose of preventing it from breaking the law ? The city 
of Toronto, Canada, has recently taken over a number of pri- 
vate boys' clubs which she will manage as part of her city 
business. This social spirit of civic responsibility has grown 
rapidly in the last few years, and we may expect more cities to 
assume responsibility for their children. 

Street Life. — As the Spartans used Mount Taygetus as a 
place to test their children by exposure, we use the streets of 
our city to-day, and without a doubt the streets offer the more 
severe test. Ninety-five per cent of the modern children are 
exposed to the hardships and dangers, physically as well as mor- 
ally, of our American cities. It is remarkable that only 12,000 



THE CITY AND HER BOYS 551 

of the 350,000 that are turned out upon the streets by the 
schools, come into an open break with the law. 

John Collier says that " play is the. way of life to the child. 
It is his means of growth, his motive for study and work, his 
greatest asset. New York City has made play a child's pitfall. 
Child crime in New York City is built on play. Juvenile crime 
is increasing more rapidly than adult crime. A child crime 
begins with the attempt to play on the streets in violation of 
the law, and in forbidden places under conditions of trespassing." 

These 350,000 children who represent perhaps only one-half 
of the children under sixteen years of age who use the streets, 
have the tremendous leisure time of two million hours on the 
average day to be spent in " street-land." Justice Hoyt of the 
New York Children's Court says: " We, who have actual ex- 
perience in dealing with juvenile delinquency, are constantly 
impressed with the fact that much of our work would be un- 
necessary if the boy had the proper environment and leadership 
during his leisure time." 

This " street-land " is so attractive that 10,000 children have 
become chronic truants. Many of the studies that have been 
made about the cause of juvenile delinquency lay great stress 
upon truancy. 

A recent survey of street life (as regards play) made by the 
People's Institute in New York, with the assistance of 400 
social workers, gives an excellent picture of the means adopted 
by the children to spend their leisure time. The children try 
to engage in wholesome play which to the city or the com- 
munity is a nuisance, but which to the child is his very life. 
There has grown up a feeling of intolerance toward the activities 
of children when they interfere with the community life. 

This survey observed 119,987 children, of whom 65,000 were 
boys, and 22,000 of these were engaged in games or occupations 
that lie on the border-land of the law. Two thousand of these 
boys were playing games that were actually violations of the 
law. Thirty-seven thousand of these children were simply 
idling, ready to be moved by any suggestion. One of the con- 
stant dangers of the child in the city are the adult individuals 
seeking recruits for various forms of evil. There were 30,000 
adults watching these children at play, a tremendous number 
when we consider that to every four children at play there was 



552 APPENDIX 

one adult who was unoccupied and interested in what these 
children were doing. 

The street trades that boys engage in are a constant problem 
to the police. There were 6,000 children absorbed in some 
form of street trading such as peddling, selling papers, soliciting 
baggage, and various other trade activities. Philip Davis, in 
his recent comprehensive study of street life throughout the 
United States, puts into the mouths of these young street work- 
ers the following appeal: 

Friends, you have permitted me in youth to squander my resources, 
instead of conserving them. You have encouraged me to sell papers 
and shine shoes since I was but a child. You have tipped me liberally, 
meaning to be good to me. In the meantime I grew up without a trade 
and now I am at the end of a blind alley. I am not as energetic as 
I was. My parents have long disowned me. I can't make a living. 
I have therefore come to the conclusion that the World owes me a living. 

The Law. — The extreme congestion of the city makes the law 
and the boy natural enemies. The law as it appeals to the boy 
is a prohibition of many actions which are but normal to him. 
What may be an infraction of the law in one locality may not 
be in another. The perfect natural play of the country boy 
would be an offense in the city. 

The policeman impresses the boy as a blue giant in brass 
buttons who belongs to the land of " Thou shalt not." But 
this idea of the policeman is being rapidly changed through the 
efforts of persons who believe that the policeman ought to be 
more than an " arresting officer"; that he should be a social 
worker, a " big brother " of all the " kids " in his block. The 
juvenile delinquent is not so much a police problem as a problem 
of education. The purpose of the children's courts is not to 
treat the boy as a criminal but rather to act in the role of a 
physician who is administering to the needs of his patients. 
The tendency is now for the parents to bring their incorrigible 
children to the court. The judge acts toward these children as a 
foster-parent. 

The policeman is the biggest factor in juvenile delinquency, 
as he brings to the court 73 per cent of the cases. Shall his 
interest stop when he delivers the boy to the Gerry Society, 
or shall it stop when the boy is placed on probation? His police 



THE CITY AND HER BOYS 553 

interest should stop with the arrest, but his social interest should 
continue as long as he is brought in touch with the boy. The 
probation officer should use the policeman as one of the agencies 
which he uses in treating a particular boy for delinquency. 

After the policeman leaves his charge in the hands of the court, 
the boy is in control of those who will bring to bear on him all 
the forces of rehabilitation. The idea of punishment is not 
paramount in the court's treatment of a case. The atmosphere 
is wholesome as compared with that of the criminal courts. 
Yet there is an element entering into the court which is dangerous 
to the boy, namely the intimate association he has with boys 
who are adult to him, and much more experienced in wrong- 
doing. There was remanded recently to the Gerry Society for 
one week a boy arrested for a minor offense. While he was 
detained by the Society he learned a good deal about things 
that are wrong which he did not know before. There was 
another case of a boy who was placed in P. S. 120 for truancy, 
who, while in this school, met boys from whom he learned to 
steal. While the offense for which he was sent to the school 
was truancy only, and not stealing, he has since been arrested 
three times for more serious offenses. 

Probation has been to many boys a means of return to a nor- 
mal life. The probation officer, considering the vast field he 
is forced to cover, does extremely efficient work with the boys. 
The officers have been able to develop considerable co-operation 
of various agencies in their work with the children. The Big 
Brother and the Big Sister movement has been of great assist- 
ance to the officers in the development of moral character in 
the probationers. 

Mr. George Everson of the Criminal Courts Committee, in 
his examination of the court record, shows that 57 per cent of 
the boys placed on probation are retarded in school. Where the 
boys have been examined, a high percentage of mental " kinks " 
have been discovered. A percentage of them may be truly 
defective, some even needing custodial care; others merely re- 
quiring the right environment and stimulus to overcome their 
defects. Their very retardation is very often the direct effect 
of unfavorable life conditions. Three boys who escaped detec- 
tion by the court were recently examined and found to be so 
defective mentally that they were a menace to society. Many 



554 APPENDIX 

are merely sufferers from physical defects which affect their 
emotional and mental equilibrium. Before a delinquent can 
receive full justice from the court, it is necessary that a mental 
and physical diagnosis be made to discover whether the cause 
of his trouble arises in his mind or in his body. 1 

If the court is to be completely efficient in dealing with ju- 
venile delinquency, it must not only pass sentence but must 
take an aggressive part in eliminating from the city life those 
elements that cause delinquency in the normal boy, and it must 
be instrumental in placing at the disposal of the boy all the 
agencies he needs to make him a completely socialized indi- 
vidual. 

Recreation. — It is through the efforts of boys to have a good 
time that they frequently get into trouble. The facilities for 
recreation, both private and public, are wholly inadequate to 
meet the demand. It is this lack of wholesome recreational 
facilities that makes the boy problem such a difficult one to 
solve. 

New York furnishes to its 500,000 boys only one hundred and 
twenty-nine acres of play space within walking distance of their 
homes. The parks owned by the city are so situated that they 
are not usable without a ten or twenty cent carfare — for the 
boys and girls that need them the most. They are really play- 
grounds for the well-to-do. Even for the lowlier dwellers in the 
near-by districts, the streets are much more interesting than the 
parks. 

The nervous life of the city has entered into the athletic ac- 
tivities of the boys. The games that they are interested in 
must have an element of excitement in them. A great many of the 
games are patterned after adult life. One of the popular games 
is " Cops and Robbers." In this game one boy is set upon by 
a number of others and sand-bagged, then robbed, and the 
group is then chased by one of the boys, who takes the part of 
the " cop." This is a direct imitation of observed crime. The 
element of chance is so strong that it is well-nigh impossible 
to arrange baseball games during the summer without a side 
bet. The chance element and financial reward has become so 

1 The author of this book has recently examined a number of boys and girls 
at the Children's Court of New York. County. His findings bear out Mr. 
Hines's statements in every detail. 



THE CITY AND HER BOYS 555 

much a part of track athletics that the word " amateur " has 
lost its original meaning. All this spirit has had its lowering 
influence upon the life of the boy. Instead of his recreation 
developing the idea of squareness, it has developed in him the 
idea to win at any cost, and his conscience is satisfied with the 
feeling that it is all right " if you can get away with it." 

The fifty-three settlements in the city furnish a considerable 
amount of the recreation to the boys. Many of these settle- 
ments maintain gymnasia and summer camps at a nominal 
cost. They furnish a greater element to the recreational prob- 
lem than the physical, namely, the socializing" element in the 
group clubs, which are nothing more than the gangs under 
adult leadership. I consider this to be the supreme contribu- 
tion of the settlements to the boy problem. In addition to the 
fifty-three settlements, New York has one hundred and twenty- 
three churches that maintain means such as gymnasia and 
club-rooms where the boys may find wholesome recreation. 

The city maintains for recreation thirty-one centres which 
accommodate about 9,000 boys. It would go a long way 
toward solving the recreation problem if all the schools were 
thrown open in the evenings to be used as social centres for the 
children. Experiment has proved that these social centres 
can be to a great extent self-supporting. 

Perhaps one of the largest factors in the recreation problem, 
outside of the street, is the motion-pictures place. The form of 
life exhibited on the screen is not the kind that the boy ought 
to see. The scenes which he frequently sees are reproduced 
in his own way, thus placing him within the clutches of the 
law. The boy has strong imitative and dramatic instincts 
which make these reproductions perfectly normal. The National 
Board of Censorship cannot censor pictures when there is such 
a wide group to consider, both for adults and the child. The 
motion pictures are in many cases an incentive to truancy, and 
also offer an excellent place for hiding while on the " hook," 
or for clandestine meetings of boys and girls. There has been 
little pretense of enforcing the age law. If the age law against 
children were in force, many of the picture-shows would go out 
of business. It might be a good thing, remembering that 
children are admitted to the theatres, always to have a matron 
present to see that the children are in no danger. 



556 APPENDIX 

The Part of the Schools. — There is no institution that has as 
much opportunity of affecting the boy as the Public Schools 
System. It reaches 278,889 children for five hours a day, and 
then, for the remainder, closes its perfectly usable buildings. 
There are 10,000 truants a year that the school evidently does 
not adapt itself to. The school systems are made to fit the 
" normal " boy, that is to say, the conforming boy, thus handi- 
capping the exceptional child whether he is above or below 
normal, or just normal with some trouble of his own. 

The result of the examination of children coming before the 
courts shows that the boys have received good memory train- 
ing, but poor training in constructive or initiative activity. 
The intellectual development that may come from books alone 
is not the one which the city boy needs; he needs experience 
that comes from some form of constructive and productive ac- 
tivity. He should not only acquire skill of hand, but it is im- 
portant that he should get an idea of the elements involved in 
all the productive processes, namely, material, labor, and time. 
The boy should acquire the ability of a master workman, the 
power to grasp a situation, and the ability to see the end from the 
beginning. It is the duty of the school to make thinkers of the 
boys. 

The obligation which the public schools owe to society does 
not end when they have developed thinkers, but their duty is 
only then completed when they have placed at the disposal of 
the boys their vast equipment for the full development of life 
opportunities. Instead of taking care of boys for five hours 
a day only, the school building should be open for use the re- 
mainder of the day and evening, and particularly on holidays. 

The public schools of the city are used only 40 per cent of the 
time, and the churches are used only 10 per cent of the time. 
The development of a boy's religious nature is absolutely essential 
to his life. 

The Church. — Boys without active church connection, or 
some other form of spiritual uplift, are pretty sure of moral 
tripping. The maximum age for delinquency is the same as 
the maximum age for the development of the religious instinct 
in the boy. Juvenile delinquents show no religious develop- 
ment. The age at which most crime is committed falls within 
the period of life known as adolescence. The boy is unstable and 



THE CITY AND HER BOYS 557 

at the same time independent, thus making his judgment un- 
trustworthy. This is the period during which he needs gui- 
dance, and it is also the most fertile period for the development of 
his religious life. It is at this time that his sex life commences 
to unfold, and that the idealistic elements of his nature begin to 
assert themselves. It is the church's peculiar debt to the boy 
to supply him with an environment of inspired religious and 
social life at this particular period. 

The church is a negative factor in the street boy's life. As an 
institution it has not adapted itself to the street boy. Its vast 
machinery is too unwieldy to adjust itself readily to the boy 
who needs it the most. New York City is dotted with churches, 
situated in the midst of the most intense social night-life; but 
yet they remain bleak and dark and unattractive in contrast 
to the cheery surroundings of commercialized amusements. 
These churches are not without equipment, and are not with- 
out attractions that are more desirable to the boy than those 
furnished by the street — if they were put before him in a form 
as enticing as the commercialized amusements. 

To give the boy this religious life which is essential to his life, 
will require more than a sermon, more than a Sunday-school, 
more than a gymnasium or social service. The minister has not 
done his duty when the sermon is over, nor is his duty done 
when the church is thrown open under paid instructors for the 
neighborhood. His duty is done only when all these social 
activities are used to inculcate the religious motive in the boy — 
not the denominational religious motive of a Protestant, Catholic, 
or Jew, the motive which divides; but the development of the 
religious spirit which fosters human fellowship and brotherhood. 
A gymnasium, unless properly supervised, can counteract all 
the good work of the minister. Foul tactics are often indulged 
in in these gymnasia with the knowledge of the instructor. 
The spirit of winning at any cost leads to the unsportsmanlike 
practices that are so common in basket-ball especially. The 
gymnasium can be used by the minister to develop moral fibre 
in the boy which, if strongly developed, will sustain his attitude 
through life. 

The church is responsible for the environment surrounding it. 
We would think the physician foolish who attempted to cure a 
contagious disease without changing the environment which 



558 APPENDIX 

contains the germs. Yet we have the religious physician at- 
tempting to cure the boys of wrong-doing while they never try 
to remove the source of the contagion. Frequently the dark 
steps of the city churches serve as hang-outs for gangs with 
vicious activities. Sunday is the maximum day for offenses; 
yet the church does not attempt to get more than an hour of 
the boy's time during that day. How frequently have I seen 
boys hurry from the church service to the neighboring pool- 
rooms, or hustle through their dinner to attend some of the 
immoral Sunday afternoon dances. The church can hope to 
get small results when it has only one hour sandwiched in 
between pool-rooms and immoral dances, for the older boys, 
and the attractive excitements of street life for the younger 
ones. If we are to judge from the outward results, we must 
admit that the environment of a boy has a stronger influence 
upon him than does the inspiration of his church. If the church 
is to discharge the peculiar duty that falls upon it, it must give 
to the boy a religion which is natural to him. 

The Working Boy. — The working boy needs attention per- 
haps more than any other normal type. There were over 
100,000 working papers issued in the last two years for boys to 
go to work. This group forms a vital part of our commercial 
life, but only one-seventh of these boys have yet the guidance 
necessary to a correct choice of vocation. Many of these boys 
are the despair of the employer, and they frequently drift aim- 
lessly from one position to another. There are so many of these 
working boys before the Children's Court that it is necessary 
to make special provision for them. 

It is from this class of boys that the pool-rooms, cheap theatres, 
prize-fights, and burlesque shows draw their financial support. 
These boys may work all day at monotonous labor, but they 
require excitement and novelty at night. You can find a group 
of them at every corner, jostling and pushing around. The 
working boy is independent, with the desires of a man, but with 
the judgment peculiar to that unstable middle period of adoles- 
cence. 

It is during this middle period of adolescence, during the 
years of fourteen to seventeen, that the boy leaves his church 
organization. It is the time of his life when he imperatively 
needs guidance and control. He needs club life, with all its 



THE CITY AND HER BOYS 559 

social and athletic activities. He should be given the oppor- 
tunity of girls' society in a healthy environment. The moral 
conditions under which he now meets his girl friends are ap- 
palling, especially the conditions in the dance-halls, which are 
more demoralizing and degrading than even those on the street. 
The dance-halls have had such a tremendous effect upon the 
social usage that it is very nearly impossible to run clean dancing 
in the various public social centres. Not only does this type 
of boy need wholesome recreation after work, but he needs 
supervision while at work; for he is thrown in contact with con- 
ditions that are often immoral and a menace to his character. 

The working-boy problem has been very successfully handled 
in such places as Fall River and Pittsfield, Mass. These in- 
dustrial towns have provided large buildings with gymnasia, 
swimming-pools, athletics, libraries, pool-rooms, dramatics, in- 
dustrial classes, amusements, and a cheery hang-out with good 
companions. These opportunities have been made attractive, 
and they are supplemented by the personal character of a strong 
superintendent. The success of a boy in commercial life de- 
pends upon how he spends his time between " quitting " and 
" bedtime." Instead of offering to her boys only the street- 
corners, pool-rooms, and saloons, the city should feel that it is 
part of her duty to provide sufficient clubs of this type, with 
the right supervision and personnel. The school buildings are 
admirably adapted to the use of the mass club. 

The Unclubbed Boy. — Society has created her institutions 
for the " normal " boys, for they are in the majority; but she 
has not made sufficient provisions for the exceptional boy. It 
is from the non-conforming, the exceptional children, either 
below or above the normal, the variations, or those that have 
become derailed through some handicap, that the criminals are 
recruited. It is for the " normal " boy, the conformist, the boy 
of full-functioning home, that the greatest amount of money is 
spent. The Y. M. C. A. reaches mainly the boys from the full- 
functioning home class. This organization has a wonderful 
equipment, and an efficient organization of workers. The Boy 
Scout movement appeals to the boy of the middle class, to the 
boy who can afford equipment and the money for trips. The 
settlements appeal to the street boy, to the boy of the congested 
districts, to the boy of the semi-functioning home — but only 



560 APPENDIX 

to the " normal " boy in these various groups. The recreation 
centres appeal to the street boy, to the working boy, and to the 
boy of the poor-functioning home. 

The unclubbed boy, the unorganized boy, the homeless boy, 
whose home is the street, furnishes the fertile soil for crime. 
This type of boy has no place in the above-mentioned organiza- 
tions. There are at least 100,000 boys that belong to the un- 
clubbed group which does not fit itself into any of the above- 
mentioned organizations. A survey recently made in the dis- 
trict bounded by Fifth Avenue, East River, 29th Street, and 
57th Street on the East Side of New York, gave the astounding 
result that only 5,000 boys and girls out of a population of 
33,000 boys and girls belonged to any club in that district. 
This leaves 28,000 boys and girls who must find their amusement 
on the streets or in some form of commercialized enterprise. 

There is little provision made for the " different," the re- 
tarded, the truant, the subnormal, the adventuresome, the 
" incorrigible," the defective and delinquent boys in the social 
organization. A probation officer recently asked a recreation- 
centre principal to take in a certain group of boys. She refused 
to have anything to do with these "roughnecks." The director 
of a settlement with a membership of a thousand boys was 
asked to take care of certain boys who had got into trouble. 
This director replied that these boys would not fit into his scheme. 
The director of one of the largest church-house settlements in 
the city, when approached in regard to some work for a group 
of boys who were troublesome, replied that it was not his busi- 
ness to handle these street boys. 

The boy of this type is a very hard problem, but an important 
problem, because in this group there is a considerable proportion 
of defectives of some kind. From an intensive study of one 
hundred cases of delinquency, the writer is firmly convinced 
that the boy who is caught when the offense is committed by 
a gang, is frequently the one with lower mental faculties, and of 
course the one least at fault. The mentally defective boy is 
so open to suggestion that he easily becomes the tool of more 
capable boys and adults. The real criminality lies with the 
more capable. A boy recently arrested for driving a wagon was 
found to be such a slow thinker that he was frequently made 
the dupe of the other boys. In another case, two boys arrested 



THE CITY AND HER BOYS 561 

for trying to kiss the teacher of an ungraded class committed 
the offense at the suggestion of older boys. Another boy is 
now in the Catholic Protectory who was made the tool of adults. 
It is this acceptance of suggestion which makes the truly defec- 
tive a danger to society. 



APPENDIX II 

A MEDICAL SYMPOSIUM 

This section is unique in that it is composed of contributions 
by a number of leading specialists who are deeply interested in 
the subject of this book, and have honored the author with 
their co-operation and counsel. They represent a very much 
larger medical constituency; for this work has succeeded in 
enlisting the earnest consideration of many practitioners and 
specialists who have given it ever-increasing attention, and who 
have encouraged the author by their sympathy and good-will 
to follow the path he had broken. 

The first contribution is by the Nestor of American medicine, 
Doctor Abraham Jacobi, who, however, is by no means agreed 
that this plan of a symposium is a good one. He writes: "lam 
interested in your subjects, and want you to go into their dis- 
cussion yourself. . . . Your book should be one man's book." 
Nevertheless, he gives the author's work his blessing in the fol- 
lowing words: 

Sfour "Tentative Classification" contains so much material, so many 
themes for extensive and difficult treatises, that it proves protracted 
studies on your part and the necessity of filling volumes even for a 
man whose life is filled with the special studies you have selected for 
your life work. . . . Feeble-mindedness, "exceptional" conditions, 
such as apply to you for correct education, training, etc., are subjects 
for medical studies, it is true; but unfortunately more objects of study 
than for improvement. On a few pages in my third edition (of 1903) 
of "Therapeutics of Infancy and Childhood," which you may have seen 
years ago, I have discussed the corresponding topics as concisely as I 
could. In my "non nocere" address before the Roman Congress of 
1894 I have discussed premature ossification of the cranium and con- 
demned operative interference. Neurological and psychiatric books 
treat of the medical (and surgical) aspects of such cases. Little's Disease, 
as you know, has been the subject of quite an extensive literature, etc. 

562 



A MEDICAL SYMPOSIUM 563 

All this shows that the anatomy and physiology of abnormal brains 
has interested a great many, but what interests you principally is the 
inability of medicine to aid you in individual cases. The causality of 
abnormal conditions of the kind has been studied, and in many indi- 
vidual cases with success. The results of such studies point to the 
possibility of prevention rather than cure. The faulty condition of the 
embryo and foetus should be influenced if possible. Diseases of those 
prenatal developments should be treated and cured. This very day 
syphilis of parents and grandparents is not sufficiently appreciated; 
accidents before and during labor may kill the new-born, or, what is 
more frequent, may add to the incompetency of the new creature for 
life. The statistics collected by Karl Pearson . . . prove that in- 
feriority of the first-born is a frequent occurrence, etc. 

It had been the author's intention to arrange the medical 
contributions in accordance with the classification of exceptional 
children which forms the basis of his discussions. But inasmuch 
as they are somewhat overlapping in content, this plan could 
not be carried out strictly. The individual contributions are 
printed without any but casual comment, even where the points 
of view expressed do not precisely coincide with the author's 
own convictions. The problem is too big to be a one man's 
problem, and although this book is intended to present more 
particularly the author's conception of it, he has felt that this 
section, at least, should be more in the nature of a forum, 
where various experiences and methods of approach should have 
a hearing. He is happy to find that the consensus of opinion, 
in most of the essential details, favors his own conception. 

I. GENERAL PROCEDURE 

By Doctor A. Emil Schmitt, New York City 

The procedure which to my mind will bring best results in the 
study and education of the exceptional child is about as follows: 

The teacher should state his or her problem regarding the 
individual child in question after making a comprehensive 
statement of the pupil's mental, moral, and physical character- 
istics as observed in school, throwing as much light as possible 
on the home surroundings and the parentage. 

The physician should then obtain the history of the early 



564 APPENDIX 

childhood, the past illnesses, and the present condition from the 
parents, and make a medicophysical examination of every or- 
gan and function of the body. 

The accompanying history form, which was used at the 
Ethical Culture School of New York, is the outcome of my ten 
years' experience at that institution, and has proved most help- 
ful and essential, especially when I made the examinations per- 
sonally. Its only drawback, in fact, was that, most of the ex- 
aminations being made by the family physicians, the standards 
varied so much, and the purposes of the examinations were so 
misunderstood that only one-third of those received were of 
value for my purpose as medical director of the school. 

The best results are therefore obtained if the examinations 
are carried out by one examiner for each institution, and the 
higher his standards of precision and technic the more satisfac- 
tory the data. Combine this with good judgment shown in the 
suggestions of remediable measures, and they will be of the ut- 
most value. 

After the remediable physical defects have been corrected, a 
neuropsychologist should examine and give his opinion on the 
neuropsychological aspects of the case. There should then be 
a full discussion with teacher, physician, neuropsychologist, 
pupil, and parent attending, with a view of having parent and 
teacher co-operate in the subsequent development of the child 
according to the suggestions made by the physician and neuro- 
psychologist, whose interest and further advice should be sought 
according to the requirements of the case. 

Accompanying Schedule 
Confidential. — The information on the record will be held in 
the strictest confidence by the School Physician and Chairman 
of Executive Committee. Part I may be filled out by the parent, 
with or without the assistance of the family physician. Part II 
is to be filled out by a physician in connection with the physical 
examination. 

PART I 
To be filled out by parent. 

Name of pupil Date Address 

Grade Room Teacher 

Nature of dwelling Age Birthplace Sex 



A MEDICAL SYMPOSIUM 565 

Family History 

Name of parents: Father Mother Guardian 

Nationality " " " 

Occupation " " " 

Health of father If dead, cause Age at death. . 

Health of mother If dead, cause Age at death. . 

Number of brothers living .... Health .... No. dead Cause 

Number of sisters living Health. . . .No. dead Cause 

Order of birth of pupil 

Past History 

Breastfed or bottlefed How long. . . .Sickly or strong babe 

First tooth at what age Walked at what age 

Talked at what age 

Dates of vaccination (smallpox) Any unsuccessful 

Check off any of the following conditions from which pupil has suf- 
fered, and state year for each affection: 

Convulsions Marasmus Rickets .... Anemia 

Diphtheria Complication (paralysis, etc.) 

Scarlet fever Complications of ear, heart,ior kidneys 

Measles Complications of ear, lungs, or heart 

German measles Chicken-pox Whooping-cough 

Mumps Tuberculosis Typhoid 

Dysentery Meningitis Infantile paralysis 

Influenza Rheumatism Smallpox 

Trachoma Other eye conditions 

Ear diseases Mastoiditis 

Nasal affections Catarrh 

Tonsillitis Bronchitis Pneumonia 

Bronchopneumonia Pleurisy Heart affections 

Nervous conditions Hysteria Epilepsy 

St. Vitus's dance Habit spasms Neuralgias 

Headaches Skin eruptions Rupture 

Injuries Fall on head 

Operations: Adenoids Tonsils Hernia 

Appendix Mastoid Other operations 

State nature of any additional affections of 

Lungs Heart Glands 

Stomach Bowels Appendix 

Liver Kidneys Other vital organs 

Present Condition 

Does pupil keep his lips apart or mouth open during day or night ? 

Use of tea, coffee, stimulants 



566 APPENDIX 

Daily quantity of cocoa. . . .meat. . . .eggs. . . .cream. . . .sweets 

Hour of going to bed. . . .Hour of rising. . . .Sleep quiet or restless. . 

Sleep with open windows Hours in open air 

Member of athletic club or recreation group. . . .Nature of exercise. 

Lessons in music (state duration and time of day) 

Lessons in languages Dancing Theatre 

Amount of home-work 



PART II 

Subjective Symptoms 

Present condition: General health Languor 

Appetite Mastication Digestion (sour eructations, gas, 

heaviness on stomach, nausea, vomiting) : 

Abdominal pain Constipation Diarrhoea 

Flatus Taking medicines of any kind 

Palpitation Short breath Nervous condition 

Habit spasms Fidgeting Bed-wetting 

Objective Signs 

To be filled out by physician. 

General appearance: Nutrition Stigmata 

Mouth-breathing Speech defects (due to tongue-tie, cleft palate, 

enlarged tonsils, adenoids, nasal obstruction, paralysis of speech 
muscles) : 

Tics Nervousness Co-ordination 

Pulse Blood-pressure. . . .Height Weight 

Chest expansion: At rest Inspiration Expiration 

Lymph glands Thyroid 

Condition of heart Heart, rate at rest. . . .After exertion 

Lungs Skin lesions (pediculi) 

Deformities of chest Spine Shoulders 

Abdomen Ptosis Distension 

Liver Spleen Stomach 

Hernia Genitalia (phimosis) 

Adolescence (menstruation) 

Knees Ankles Feet 

Gait Posture, standing Sitting 

Hearing (watch-tick): R L Audiometer: R L 

Condition of ears : R L 

Vision: R L Both Astigmatism: R L 

Wearing glasses (how long) When last corrected 

Condition of eyes Conjunctivae 

Strabismus Pupils Nystagmus 



A MEDICAL SYMPOSIUM 567 



Lips Teeth (malocclusion) 

Tartar Caries 

Tongue Palate Uvula 

Tonsils Pharynx Nasopharynx. . . 

Nose Breathing through nose 

Hemoglobin Blood-count 

Urine : Spec. Gr Indican Albumin Sugar . 

Remarks and recommendations to school physician: 



Note. — Cf. this schedule with the schedules proposed in the author's book, 
"The Study o£ Individual Children." 



II. PHYSICAL CAUSES OF GENERAL AND 
MENTAL DEFICIENCIES 

By Thomas D. Wood, M.D., New York 

Statistics of Physical Defects/ A study of the physical causes 
of general and mental deficiencies among school children re- 
veals facts, and leads to conclusions, which are of striking 
significance. 

From 60 to 75 per cent of all school children possess physical 
defects which are potentially, if not actually, detrimental to 
health and general efficiency. Health in this relation is to be 
considered as affecting physical, mental, moral, and social well- 
being. Fortunately for the children, and for the nation, most 
of the defects are partially or completely remediable. 

The statistics of these physical defects among school children 
vary widely according to the standards used for the examina- 
tion of the children and, in part, according to the locality in 
which the examinations are made. It is difficult, therefore, to 
give a general estimate of the number of children handicapped 
by the various defects. 1 There are in the schools of the United 
States to-day something over 20,000,000 pupils. Careful study 
of statistics and estimation of all conditions lead to the follow- 
ing general estimate: 

From (\}4 to 2 per cent) 300,000 to 400,000 of these have 
organic heart-disease. 



568 APPENDIX 

Probably (5 per cent) 1,000,000 at least have now, or have 
had, tuberculous disease of the lungs. From recent investiga- 
tions it seems probable that a much larger percentage of chil- 
dren (perhaps 25-30 per cent) have received in some part of the 
body before the age of entering school the primary foci of 
tuberculous infection, which may serve as the sources of more 
or less serious tuberculous disease later. 

Over (5 per cent) 1,000,000 have defective hearing. 

About (25 per cent) 5,000,000 have defective vision. 

About (25 per cent) 5,000,000 are suffering from malnutrition, 
in many cases due in part at least to one or more of the other 
defects enumerated. 

Over (30 per cent) 6,000,000 have enlarged tonsils, adenoids, 
or enlarged cervical glands which need attention. 

Over (50 per cent) 10,000,000 (in some schools as high as 98 
per cent) have defective teeth which are potentially if not 
actually detrimental to health. 

Several millions of the children possess each two or more of 
the handicapping defects. 

Dental Defects. — The defects of the teeth are most numerous, 
and very few intelligent people even appreciate as yet the actual 
or possible injury to health that may result from defective 
teeth. Sir William Osier has said with great confidence that 
he believes defective teeth cause more physical deterioration 
among children in Great Britain than is produced by alcohol. 

Country Children More Handicapped. — Comparative study 
of statistics of physical defects among children of city and 
country schools has brought to light the astonishing fact that 
country school children are handicapped by more physical de- 
fects than are children in city schools. All available statistics 
of mental defects show the same striking relationship; that is, 
a greater number of mentally defective children are found among 
rural school children than among those in city schools. 

Physical Defects Interfere with Mental Development. — Care- 
ful study of the possible influence of the various physical de- 
fects upon mental health and efficiency leads to the conserva- 
tive conclusion that most of these physical defects may interfere 
to some extent with normal mental development, and some of 
them may have a direct causal relation to actual mental defi- 
ciency. Comparison of statistics with professional opinions 



A MEDICAL SYMPOSIUM 569 

shows a great variation in judgment regarding the extent of 
mental retardation caused by physical defects alone; but there 
is abundant ground for the belief that the influence of all the 
physical defects affecting childhood loom important even as com- 
pared with defective heredity in producing various forms of 
mental handicaps. Fortunately, most of the mental retardation 
or deficiency produced by physical defects alone may be cured 
entirely or in great part if these defects are recognized in time, 
and are corrected to the greatest possible degree. 

Early Detection of Defects. — It must be considered, then, of 
the greatest importance to the race, to the nation, to the com- 
munity, as well as to the individual child, that all of these defects 
should be detected at the earliest possible moment by a thor- 
ough and efficient method of examination, and that the com- 
munity or the State should provide adequate means for cor- 
rection and treatment. 

Necessary Provisions. — The necessary provisions for such 
health care are comprehended in the following: 

I. Health examination and supervision of all school children. 

II. Dental examination and dental care for the teeth of all 
children in the schools. 

III. The service of the school or district nurse to provide 
the practical health service and follow-up work which (it has 
been so clearly demonstrated in our cities) can be best accom- 
plished by the school nurse. The work of the nurse is even 
more vitally important in rural than in city schools. 

IV. Warm school lunches for all children in rural as well 
as in city schools. The indirect educational benefits of the 
school lunches upon the children and the homes are even more 
important than the immediate health improvement of the chil- 
dren themselves. 

V. Correction of physical defects which are interfering with 
the health, the general development, and the progress of the 
children. For this remedial, preventive, and constructive health 
service a rational socialization of medical care is needed to in- 
sure the best attention that medical knowledge and skill can 
provide. Such a comprehensive health programme involves, 
both in country and city, community health centres, clinical 
facilities, medical, dental, surgical, and others, sufficient to 
meet the needs of the children. 



570 APPENDIX 

VI. Co-operation of physicians, medical organizations, health 
boards, and social organizations in the health programme of the 
schools. 

VII. Effective health instruction for all pupils, which shall 
aim decisively at the following results: 

(a) Establishment of health habits and inculcation of lasting 
ideas and standards of wise and efficient living in pupils. 

(b) Extension through the pupils' effort and influence of health 
conduct and care to the school, to the homes, and to the entire 
community. 

VIII. Provision of adequate space, facilities, and supervision 
for wholesome motor activities — play, recreation, and games. 

IX. Better-trained and better-paid teachers for the schools, 
who shall be adequate to meet the health problems as well as 
the other phases of the work of education. 

Present Status of Health Service. — Measures for the adequate 
detection and treatment of health deficiencies are being rapidly 
put into use in many States of the Union. About four hundred 
cities in our country have some form of medical inspection of 
school children. The relative efficiency of the systems employed, 
however, varies greatly. 

The rural schools are far behind the city schools in making 
provision for the health care of the children, just as the standards 
of living and of health care in rural America are decidedly in- 
ferior to-day to corresponding standards and care in our cities. 

Mentally Backward and Deficient Children. — The adequate 
treatment of school children who are mentally backward or 
really mentally defective involves two different procedures: 
First, both classes should be freed to the fullest possible extent 
from all physical defects. Secondly, special educational pro- 
visions should be made for them. Those who are only back- 
ward, or were handicapped by removable physical defects, 
should be given all the educational advantages which their 
special cases require. Children, on the other hand, who possess 
inherent mental deficiency should be treated in special schools 
which should be provided in every community, whether urban 
or rural. 



A MEDICAL SYMPOSIUM 571 



III. PRENATAL AND NATAL CAUSES OF EXCEP- 
TIONAL DEVELOPMENT IN CHILDREN 

By Doctor Ira S. Wile, New York City 

Beginning of Life. — In general, educators begin their inter- 
ests in children when they present themselves for schooling. 
It is undoubtedly true, however, that the incapability of chil- 
dren to take advantage of educational opportunities is largely 
dependent upon their physical health and heritage, developed 
by environment during the years preceding entrance into the 
pedagogical world. The beginning of the life of a child dates 
back to his conception, and must not be regarded merely as 
coincidental with his birth. 

The brain development of children is affected by various 
factors so markedly that one must consider cerebral organization 
during intrauterine life, the natal period, in addition to the 
postnatal years. The actual development of the cerebral cells 
during intrauterine life is of maximum importance. If there 
is failure of cerebral cellular development or the brain cells are 
imperfectly developed, there will naturally result some form 
of mental incapacity, varying from idiocy to the moron state. 
The actual failure of development of cellular substance in the 
brain may be due to causes inherent in the germ-plasm. Gross 
injuries of the brain or its coverings occurring at the time of 
birth may interfere with mental development so as to later 
retard school progress. 

Exceptional Development. — Exceptional development is not 
infrequently started during the prenatal period. The struc- 
tural or functional variations are of two types during the pre- 
natal months. They may be hereditary or germ-plasmic in 
origin, or they may be acquired intrauterine variations. This 
distinction is made because the term " congenital " is frequently 
applied so as to include all conditions existent at the time of 
birth, though part of these should be distinguished as hereditary. 

During the natal period, disabilities may result incapacitating 
children to function normally, and requiring special forms of 
education. The physical and mental defects resultant there- 
from may be due to infection or traumatism. 



572 APPENDIX 

During the prenatal or natal period children may be handi- 
capped physically through a sensory defect, a motor defect, 
or a cerebral defect. Sensory defects would include functional 
variations, diseases, or deformity of the special senses, as sight 
and hearing. Motor defects, interfering with the normal develop- 
ment of the neuromuscular system would include paralyses, 
amputations, and special deformities. Cerebral defects are rep- 
resented by the agenetic type, in which a failure of brain-cell 
development occurs; the dysgenetic form, in which the cellular 
development is imperfect in form; and the par agenetic variations, 
where originally normal brain cells are vitiated in activity 
through superposed disease. 

Heredity and Environment. — It is needless in this special dis- 
cussion to dwell upon the relative importance of defects due to 
heredity and those occasioned by environmental maladjust- 
ments. It is probably safe to state that heredity, with its various 
potentialities, requires a favorable environment for its maximum 
evolution and most favorable developments. 

Redemption of Childhood. — With the development of a so- 
cial consciousness, child nurture has received a relatively more 
important position than during previous centuries. The dis- 
abilities due to prenatal or natal agencies no longer necessarily 
lead to death, or to a concealed vegetative existence. Society 
is seeking to redeem childhood and to preserve for itself all 
children, regardless of their handicaps. Life thus being retained, 
an obligation rests upon communities to afford the fullest op- 
portunity to such children for the development of their physical, 
mental, and moral possibilities into actualities productive of 
good character, capable citizenship, and vital service. The lim- 
itations of children arriving at the school age merely increase 
the responsibilities of educational authorities to afford them 
every opportunity of receiving the best type of education for 
which each child is adapted. 

Special Defects. — In a consideration of defects incidental 
to prenatal influences, one is immediately confronted with an 
exceedingly large variety of conditions interfering with normal 
educational development. Just as the racial factors in heredity 
may be determinative of the size of individuals, and as family 
relationship may influence physical and mental resemblances, 
so there may be inherent in the germ-plasm, either because of 



A MEDICAL SYMPOSIUM 573 

the presence of special determiners or the absence of particular 
determiners, intrinsic variations which predetermine the neces- 
sity of special education. Illustrative of this, one immediately 
thinks of such conditions as juvenile cataract, glaucoma, and 
polydactylism. Similarly, a lack of special determiners may 
cause the development of children suffering from albinism, nyc- 
talopia, hemophilia, deaf-mutism, cleft palate, color-blindness, 
imbecility, idiocy, and epilepsy. Psychoses and neuroses result 
from neuropathic inheritance. Migraine may develop from 
the same cause. On the other hand, the nervous instability 
may eventuate in precocity or genius. Speech defects may 
be inherent in hereditary factors latent in the germ-plasm, 
and not counterbalanced by favoring environment and 
training. 

Racial Immunities. — From another standpoint one must con- 
sider even the inheritance of racial immunities, as, for example, 
the lower susceptibility of the negro to yellow fever, or com- 
pared with the negro the lower susceptibility of the whites to 
tuberculosis. The negro is less liable to acne, lupus, and irri- 
tation by animal parasites. Favus is more likely to occur 
among Italians and Hungarians. Amaurotic family idiocy is 
almost exclusively found among Jews. 

Equally vital from the standpoint of inheritance is the rela- 
tive degree of resistance or immunity to disease. Even among 
the skin diseases one may enumerate the inheritance of ichthyosis 
and psoriasis, exanthema multiplex, and predispositions to 
eczema. In passing, one must also recall the existence of hered- 
itary cerebellar and hereditary spinal ataxia, particularly 
Friedreich's ataxia. 

These various conditions all result in the birth of children 
physically or mentally handicapped who, if they reach the school 
age, require special adaptations of education in order to receive 
thei^proper development. 

Other Intrauterine Anomalies. — The conditions which are 
prenatal though not germ-plastic in origin are due to faulty 
development or injuries during intrauterine life. They also 
present types of exceptional children who later merit special 
consideration. Among the numerous anomalies of development 
one need only think of intrauterine amputations, congenital 
heart-disease, cretinism, spina bifida, chondrodystrophy, dwarf- 



574 APPENDIX 

ism, clubfeet, hydrocephalus, hernia, microtia, and congenital 
absence of the middle and internal ear. 

Many of the speech defects, because of the intimate relation 
between disorders of speech with the development of the organs 
of speech and the cerebral centres of intelligence, are to be 
regarded as results of developmental anomalies. Such types of 
speech defects may be due, for example, to a congenital occlu- 
sion of the posterior nares, or to the shortness of the geniohyo- 
glossus muscle, or to tongue tie. 

Care of the Prospective Mother. — In order to safeguard the 
child during the period of prenatal life, in so far as may be 
possible, it is essential that the prospective mother place herself 
under the direction, supervision, and guidance of a physician 
carefully selected because of his ability. The longer the preg- 
nant woman is under medical care, the greater is the likelihood 
of her escaping miscarriage, and a gyeater advantage appears 
to accrue to the unborn child. Prenatal care thus far has in- 
dicated that the mortality rate during the first month of life 
may be cut in half, and those disabilities not due to inherent 
defects of the germ-plasm decreased to a remarkable extent. 

Natal Causes. — The natal causes may be infections with 
gonorrhea, producing the blindness of the new-born, or syphilitic 
infection at birth, with its later evidences of interstitial keratitis, 
progressive deafness, large lymph-glands, and ulcerations of the 
throat. There may be paralysis from blood-clots on the brain, 
or obstetrical paralysis, particularly those of the upper arm 
(Erb's paralysis) or the lower arm (Klumpke's paralysis). 

The importance of excellent obstetrical and nursing care at 
the time of childbirth cannot be overstressed, in order to obvi- 
ate diseases and deformities incident to the forces operating in 
childbirth, such forces being either internal or external. 

Adjustment to Individual Needs. — Even this brief resume is 
indicative of the large variety of conditions among children of 
school age that are due to prenatal or natal factors. The vari- 
ous conditions mentioned may be productive of various school 
types of exceptional children. They may be characterized by a 
varied group of symptoms which are discouraging to pupil, 
parent, and teacher in connection with educational development. 
The children may be nervous, irritable, restless, quiet, inatten- 
tive, sensitive, diffident, shy, self-conscious, apathetic, retiring, 



A MEDICAL SYMPOSIUM 575 

hysterical, uncommunicative, headstrong, explosive, emotional, 
passive, vegetative, unsocial, antisocial, quick or dull in sen- 
sory or motor reactions, incapable in some special work involving 
a sensory or motor mechanism, suspicious, fearful, fatigued, 
backward, and disinterested. They may be blind, deaf, mute, 
with speech defect, with skin eruptions, faulty dentition, cutane- 
ous disease, or some evident physical impairment or disability 
in gait or with inco-ordinate muscular movements. 

It is not necessary to specify the particular physical and 
mental conditions arising in connection with each specific 
handicap. It is patent that children of all these types require 
special attention. Educational methods must be adjusted to 
individual needs. Auxiliary classes are essential so that the 
children from these groups may be attended to. There should 
be classes for the blind, the crippled, the deaf, for children with 
cardiac diseases, speech defects, etc. 

In order to secure the maximum educational results, the cur- 
riculum must be sufficiently elastic to permit of the widest 
modifications, while adequate pedagogical methods must be 
constantly devised for the manifold needs of these no less than 
other classes of exceptional children. There is a wealth of so- 
cially constructive thought bound up in the fact that this handi- 
capped element of the school population is the victim not so 
much of the failure of a postnatal environment as of dysgenic 
factors existent before or at the time of actual birth. 



IV. MEDICOEDUCATIONAL METHODS IN THE 
TREATMENT OF ATYPICAL CHILDREN 

By Doctor C. Hudson-Makuen, Philadelphia 

Medicoeducational Methods. — The term "medicoeducational" 
is one that is frequently used and it explains itself, but its 
successful application as a system of treatment depends entirely 
upon the judgment of the physician. 

Medicoeducational methods are applicable in a measure to 
all classes of patients, but they are especially indicated in the 
treatment of so-called atypical children, and as Doctor Oliver 
Wendell Holmes has suggested, to be curative in every instance 



576 APPENDIX 

they should be instituted several generations before the birth 
of the child. 

Medicoeducational methods, therefore, have a twofold func- 
tion: namely, the prevention of disease and the cure of it. 

Principle of Eugenics. — The principle of eugenics has been 
advocated as a means of preventing disease, and but for the 
difficulties of establishing or enforcing the principle it would 
doubtless be of great value. The chief obstacle also to the suc- 
cessful practice of any medicoeducational methods, whether 
for the prevention or cure of disease, is the difficulty arising, 
first, in outlining a suitable course of procedure, and second, in 
seeing that the course is properly carried out. 

The Medicoeducationalist. — To successfully meet these diffi- 
culties the medicoeducationalist must be a specialist in the true 
sense of the term. He must be a medical man and an educational 
man; he must be at once a physiologist and a psychologist, a 
physician and a teacher; he must know his medicine well, and 
he must know the workings of the human mind equally well. 
He must know not only what should be done for the prevention 
and cure of certain abnormal conditions, but he must know 
how to do it, and how to teach others to do it. " To do " is 
not as easy as " to know what to do," and the great medico- 
educational problem is to make men do the things that are good 
for them, and leave undone the things that are not good for 
them. 

Psychological Conditions. — Failure in the successful applica- 
tion of medicoeducational methods of treatment is often due 
to the physician's own lack of belief in them. If we would con- 
vince another of the error of his ways, we must ourselves be 
keenly alive to the error; and when we have once really convinced 
our patient of his error, we have him in the true psychological 
condition for the adoption of means which make for its complete 
eradication. 

Physicians are constantly making the mistake of separating 
the mind from the body in their diagnosis and treatment of dis- 
ease, and this is especially true in the diagnosis and treatment 
of diseases of childhood. 

Mind and Brain. — The mind of the child is always a product 
or function of the child's brain, and defective mentality always 
suggests a defective action in some of the cerebral structures. 



A MEDICAL SYMPOSIUM 577 

This defective action does not necessarily indicate organic cer- 
ebral defects, but it may be due merely and wholly to a bad 
start in the growth and development of the brain tissues. 

A study of child psychology teaches us that of all the organs 
of the body the brain is the most susceptible to physical and 
functional development. The cerebral convolutions increase 
enormously in number, and the enveloping gray matter, which 
forms the so-called cortex of the brain, undergoes a correspond- 
ing increase in its surface growth during what we call mental 
development. 

Moreover, the so-called associational fibres of the brain, upon 
which its mental functions so largely depend, are merely rudi- 
mentary in early childhood, and only attain their full functioning 
powers after years of growth and development. 

These anatomical and physiological facts must be taken into 
consideration in the application of medicoeducational measures 
in the treatment of children. Even the normal child should be 
given plenty of time for physical development before any special 
mental development is attempted, always keeping in mind his 
physical and psychical limitations. 

Difference Between Normality and Abnormality. — A striking 
difference between the mentally normal and the abnormal child 
appears in the fact that the one develops automatically, while 
the other halts in his development, or actually, in some instances, 
loses ground or undergoes a retrograde development. 

Psychophysical Education. — The physician's aim in the treat- 
ment of all children should be to assist them in both their 
physical and mental development. The phrase that best ex- 
presses this work is psychophysical education, or, better still, 
physicopsychical education, because the physical education 
precedes the psychical and forms its basis. 

Concentration. — It has been found that doing things with 
purposeful intent has a far greater educational value than doing 
things at random, or with no special object in view. Concen- 
tration, therefore, upon the thing in hand should always be the 
watchword in the psychophysical training of children, and ob- 
serving a daily improvement in the child's faculty of concen- 
tration constitutes one of the greatest pleasures in connection 
with carrying on this work. 

The physician, above all else, should be a teacher, because of 



578 APPENDIX 

his numerous opportunities for teaching how to avoid disease 
as well as how to recover from disease. 

Two Important Elements. — The two important things to keep 
in mind in the psychophysical education of children are, first: 
a correct postural attitude, and, second, correct breathing. 
These two things have been said to constitute a cardinal prin- 
ciple in the treatment and prevention of disease, and at all events 
they should form the starting-point of all medicoeducational 
systems of treatment. Their application in the case of normal 
children is comparatively simple, but in atypical or subnormal 
children the problem is more difficult and more complex. 

Correct Postural Attitudes. — To teach correct postural atti- 
tudes requires much knowledge, patience, and skill on the part 
of the physician, and for the child to acquire and develop normal 
orthograde positions of the body requires a considerable well- 
directed practice on his own part. 

Moreover, this practice, to be of psychical as well as physical 
benefit, should have a purpose in view, and it should be carried 
on volitionally and under the direction of the mind. Such 
physical exercises have a value far beyond that which is usually 
attributed to them, and when they can be made use of in the 
training of atypical or otherwise exceptional children they 
should not be neglected or entirely supplanted by the usual 
methods of manual training. 

Correct Breathing. — Physicians differ widely as to just what 
correct breathing is, but nothing is more important in the 
physical development of the child than the acquirement of nor- 
mal and efficient respiratory habits. Such habits, to be sure, 
are likely to follow naturally upon correct postural attitudes, 
especially in normal children. But in atypical, subnormal, and 
abnormal children they must be acquired, oftentimes by per- 
sistent practice, sometimes covering long periods of time. 

Speech Training. — The psychophysical education, to which I 
have referred, should precede and accompany speech training, 
which should constitute an important factor in all this work, 
because of its close relationship to the mind of the child. 

A Forcing Process. — Atypical or backward children should 
not be coddled but encouraged, and, like plants of slow growth, 
in some instances they should be " forced." This may be done 
by supplying favorable conditions for growth and development, 
and by directing their physical activities in the right channels. 



A MEDICAL SYMPOSIUM 579 

Comparative ill health is not always a contraindication, but 
oftentimes a decided indication for this forcing process. Many 
a child immediately begins to improve physically as well as 
mentally when well-directed pressure is brought to bear upon 
him in psychophysical education. 

It is not enough to merely lead these children, but they 
must, in a measure, be driven, and in this way they soon find 
that in the words of the country boy who went to hear Rubin- 
stein play the piano: " It is happier to be miserable than to be 
happy without being miserable." 

V. MALNUTRITION 

By Doctor Ira S. Wile, New York City 

Definition of Malnutrition. — Among the various problems re- 
lating to the physical health and educational welfare of public 
school children, none is less understood or more misunderstood 
than malnutrition. The statistical side of medical inspection 
has thus far failed to establish satisfactory or definite relations 
between malnutrition and specific physical defects. The term 
" malnutrition " has not been clearly defined, and its connota- 
tions are so numerous as to confuse the entire problem. 

Hogarth has defined malnutrition as an " abnormal or dis- 
ordered growth in the development of the tissues and organisms 
of a child's body not necessarily synonymous with under- 
feeding "; and he wisely states: " Malnutrition is at once the 
most common, and until recently the least observed of all the 
unrecognized diseases and affections among children attending 
elementary schools." From this definition it is apparent that 
malnutrition is not concerned with breakfastless children, but 
with all the children who for long periods of time are receiving 
at home a dietary that is not adapted to their needs, and in 
consequence of which there is marked physical or mental de- 
terioration. 

Extent of Malnutrition. — The extent of malnutrition has not 
been scientifically determined. The figures available for vari- 
ous communities vary according to the personal equations of 
the medical inspectors noting these defects. MacKenzie re- 
gards one-third of all the school children in Edinburgh as poorly 
nourished. Warner and Tuke found 28.5 per cent of London 
school children suffering from deficient feeding. Estimates of 



580 APPENDIX 

malnutrition in New York City vary from 5 per cent to 40 per 
cent, with 15 per cent adjudged to be marked cases of mal- 
nutrition. In Chicago in 1908, 12 per cent, and in Boston, 
1909, 16 per cent, of the children examined were reported as 
suffering from malnutrition. Thomas D. Wood regards 25 per 
cent of the school children in this country as suffering from mal- 
nutrition. 

Causes of Undernourishment. — While the causes of under- 
nourishment are exceedingly numerous and closely connected 
with sociological problems as housing, overcrowding, low wages, 
underemployment, alcoholism, poor hygiene, and ignorance of 
food values, it is impossible to attack these causal factors in 
specific instances unless malnutrition itself has been recognized. 
Poor assimilation, insufficient clothing, overstimulation, worry, 
grief, anxiety may also enter into the basic causes leading to 
individual states of malnutrition. It is patent that the initial 
step and the solution of the problem of chronic undernourish- 
ment is the determination of the existence of malnutrition. 

Symptoms of Malnutrition. — The symptoms of malnutrition 
which are too frequently overlooked or insufficiently considered 
are anaemia, with various types of blood deficiencies, pallor, 
harsh and inelastic skins, muscular weakness with spinal cur- 
vatures, or flatfoot, carious teeth, squints, diseases of the ex- 
ternal eye, lassitude, inattention, twitchings, backwardness, 
and mental dulness. The height, weight, and chest measure- 
ments are usually below par. The stunted growth, the delayed 
physical and mental development, the weaknesses of the muscles, 
the increased susceptibility to infectious diseases, and marked 
liability to tuberculosis may all be related to a greater or less 
extent to a more fundamental condition of malnutrition. 

While coefficients of growth and vital capacity have been 
determined, they are not to be relied upon as final determinants 
in diagnosing malnutrition. At times valuable information 
may be secured by the application of Oppenheimer's formula 
which makes the index of nutrition equal 

Girth of the arms (midway between shoulder and elbow) 
Chest girth (average of inspiration and expiration) 

This should equal at least 30. 



A MEDICAL SYMPOSIUM 581 

During the early years of school life, nutrition may suffer 
from educational maladjustments. The metamorphosing years 
preceding puberty severely attack nutrition, and it has long 
been recognized that the chronically underfed or malnourished 
child requires a longer period of time for pubertal development 
than his better cared for brother or sister. 

Effect of Malnutrition. — The prepondering proportion of den- 
tal defects should call attention to the important fact that the 
permanent teeth develop during the school period. There ap- 
pears to be an important relation between deteriorated denti- 
tion and malnutrition. 

Insufficient thought has been devoted to the effect of under- 
nourishment during the years of life previous to school work. 
It is quite possible that the relative starvation in proteins, lime, 
iron, calcium, and magnesium during the first five years of life 
helps to produce the school child suffering from malnutrition. 

Unfortunately, the diagnosis of malnutrition is rarely made 
if any other defect is present. The dependence of defects, like 
anaemia, adenitis, chorea, tuberculosis, visual defects, mental 
dulness and increased susceptibility to infections, upon mal- 
nutrition, or their interdependence, or their coincidence, is not 
uniformly entered into the record. In consequence, corrective 
measures are not applied. 

Chronically underfed children are more vulnerable to con- 
tagious diseases and more susceptible to protracted colds and 
bronchitis. Not only are they more likely to fall victims to 
disease, but for the same reason their convalescence is retarded, 
their complications are more numerous, and their loss of educa- 
tion and training exceeds that of other children of the same age 
in a better state of nutrition. 

In so far as defects of vision are related to malnutrition, it is 
obvious that the visual approach to the mind presents many 
obstacles to the undernourished child. Mental dulness is by 
no means uncommonly dependent upon a state of chronic mal- 
nutrition. 

Nutrition Records. — Regardless of the primary factor in mal- 
nutrition, whether it be due to a deteriorative reaction against 
an oppressing physical environment or to unhygienic home 
conditions, or to lack of adequate or insufficient food, no child's 
physical record should be regarded as complete without some 



582 APPENDIX 

notation regarding the state of his nutrition. This position is 
strengthened by the comment of the Chief Medical Officer of 
London, iqio: " It is certain that malnutrition and physical 
defects are closely associated, and react upon each other, but it 
is difficult to determine their exact relation to each child, or to 
say in what degree malnutrition causes the other physical evils. 
Merely to increase the supply of food would, in many cases, 
not solve the complex problem of the individual child, although 
in many cases lack of food lies at the root of the mischief." 

Interdependence of Conditions. — The extent to which mal- 
nutrition is causative of physical defects, or the degree to which 
physical defects are responsible for malnutrition has not been 
determined. Their interdependence appears to be certain, or 
their coincidental occurrence may be due in part to their mutual 
dependence upon a series of basic factors underlying the health- 
ful functioning of the human body. 

Solution of the Problem. — The solution of the problem of mal- 
nutrition is not at hand, nor will it be until medical inspectors 
give greater consideration to malnutrition. Considered as a 
unit defect, it possesses unusual significance in a constructive 
programme for the establishment of the preventive and cor- 
rectional methods so necessary for the protection or the conser- 
vation of school children. Considered from the standpoint of 
education, malnutrition is undoubtedly a factor in retardation, 
elimination, and mediocre, or worse, school work. The powers 
of attention, concentration, memory, and directive effort are 
undermined in children whose blood tissues are lacking in the 
elements necessary to normal function. There is more than a 
grain of truth in Bacon's statement: " The brain is in some sort 
in the custody of the stomach." 

From the standpoint of prevention, the school environment 
with its poor air, overstrain, excitement, and attendant worry 
demands frequent inspection lest it serve to destroy appetite 
and impair digestion with a resultant deterioration in nutrition. 

Special cases of malnutrition demand various treatments from 
the educational standpoint according to the underlying causal 
factors. Obviously, poverty in the home cannot be directly rem- 
edied by the school, but the institution of school lunches may serve 
to partially correct the disadvantage of the home environment. 
Special classes for ancemics and open-air classes for children 



A MEDICAL SYMPOSIUM 583 

physically impaired appear to be essential in order to prevent 
further malnutrition or to correct nutritional defects whenever 
noted. The correction of physical defects interfering with diges- 
tion or calling forth unnecessary expenditures of energy are pre- 
requisite of any systematic endeavor to remedy malnutrition. 

The social disabilities effecting undernourishment may be at- 
tacked through the institution of school nurses, home and school 
visitors, or through the direct utilization of the various social 
and philanthropic agencies seeking to improve the welfare of 
families in the community. 

Determination of Malnutrition. — Beyond a doubt, the first 
step in the solution of the problem is the actual determination 
of malnutrition. The potentialities of educational measures are 
dependent upon the state of nutrition. Nutritional deficiencies 
cannot be overcome until a thorough investigation has been made 
along modern scientific lines in order that there may be reached 
a uniform conception of malnutrition itself, the basic causes 
operating to produce it, together with such essential reconstruc- 
tive measures in our educational institutions as will enable 
them to cope successfully with all phases of the problem. 

VI. CLINICAL STUDIES AND OBSERVATIONS IN 
THE MOUTH OF THE EXCEPTIONAL CHILD 

By Arthur Zentler, D.D.S., New York City 

Oral Hygiene. — The oral hygiene movement has made such 
gigantic strides in . the last few years, all through the entire 
civilized world, that it must reach out to the problem of the 
atypical child. 

If it is at all true that it plays an important role in the life 
of the " typical " child — and who will gainsay this to-day? — 
then it certainly must be true that oral hygiene is doubly im- 
portant in the life and redemption of the " atypical " or other- 
wise handicapped child. 

If the lack of proper mouth conditions in any given case is 
not the only reason preventing the child from rising from the 
atypical state into the typical, from the subnormal into the 
normal, it certainly is an impeding factor. 

In order that this be clearly understood it behooves me to 



584 APPENDIX 

give not only a brief definition of oral hygiene, which means 
health of the mouth, but to explain it in its broader mean- 
ing. 

Meaning of Oral Hygiene. — Oral hygiene, aside from complete 
asepsis of the hard and soft structures of the mouth, implies the 
constant keeping of each tooth individually in such condition, 
and all teeth collectively in such relation to each other, as to 
preserve normal occlusion, which means that when the mouth 
is in a state of repose all the teeth should be in such contact 
as to afford to each other the greatest possible support — which 
contact will enable their occlusal surfaces to give the greatest 
possible service in the act of mastication. 

Pictures Nos. 48, 49, and 50 represent the casts of the same 
mouth where the left side is in normal occlusion, showing the 
contact spoken of, while the right side is thrown into mal- 
occlusion, because of the extraction of only one tooth, thus 
showing lack of contact. 

How Early Should Care of Mouth Begin? — The desire to 
obtain the ideal conditions of normal occlusion would lead one to 
the natural question of how early one must begin the care of 
the mouth. I believe I have answered this question in my 
essay l read before the Section on Stomatology of the A. M. A. 
at its annual meeting of 191 1, written with the purpose of point- 
ing out that the care of the teeth of the child must begin in the 
mouth of the mother during pregnancy. 

During infancy the foundation to well-developed jaw-bones 
should be breast-feeding as against bottle-feeding, the former 
stimulating growth through activity, while the latter does not 
possess this advantage. After weaning, it is essential that a diet 
requiring thorough mastication be observed. Mushy foods so 
generally used should be replaced by dry toast, not such softened 
by liquids; meat broths should be replaced by the actual meat 
given the child to chew on, of course care being taken that only 
the juice is swallowed, etc. This admonition as to eating such 
foods which need thorough mastication holds good from baby- 
hood all through the rest of one's life. 

Scrupulous cleanliness of the teeth must begin with the 

1 "Oral Development in Progeny Influenced by the Buccal Tissues During 
Pregnancy." 



A MEDICAL SYMPOSIUM 585 

emerging of the first tooth in the baby's mouth, and be continued 
throughout life. 

Caries. — If in spite of all care, caries make their appearance, 
the lost portion of a tooth must be so replaced that the original 
shape of the tooth is again obtained. Nothing short of this 
will answer the purpose of oral hygiene in its broadest sense. 
If any one or more teeth are lost they must be replaced, and 
this in such a manner as to afford to the adjoining and opposing 
teeth that contact of which I spoke in the beginning. 

Wrong Alignment. — If from prenatal or postnatal causes the 
jaw-bones have failed to develop normally, and thereby teeth 
emerge or shift into wrong alignment, the cause for lack of jaw 
development must be ascertained, removed if possible, and nature 
aided through artificial stimulation to properly develop the 
jaw-bones, i. e., if indications for future narrow dental arches 
are present appliances should be anchored on the teeth as early 
as their shape will allow it, for the purpose of expanding the 
jaw, etc. 

Other Pathologic Manifestations. — Pathologic manifestations 
of less ordinary occurrence such as cleft palate, harelip, etc., 
must of course be attended to in earliest infancy. 

If, however, for one or another reason, proper mouth condi- 
tions do not exist, the child so afflicted will show the evil sequelae 
in a more or less marked degree. This will be in proportion to 
the seriousness of the defects, although even minor defects have 
their influence as well upon the physical as upon the mental 
status of the child. 

The Mouth as a Cause of Retardation. — It will, therefore, be 
easy to understand that even where the general clinical history 
points to negative findings, a thorough examination of the mouth 
may contribute to the discovering of the reason of a retarded 
mental development, as, for instance, in the following case: 

The casts of the mouth of C. G., Case 77, 26 years old (Figs. 
51 and 52), whose clinical history runs as follows: Male, only 
child, no hereditary traits reported, deficient animation at birth, 
some convulsions during teething, had diphtheria at 1, language 
developed slowly, walked and talked at 3, had measles at 9, 
tonsils removed at 10, is undersized and heavy, and mental de- 
velopment at present is like that of a child of 12 or 13. 

When one considers that among all the evil effects resulting 



586 APPENDIX 

from the abnormal condition found in the mouth of C. G., such 
as poor assimilation due to improper mastication, etc., improper 
oxygenation due to faulty respiration, the cause of the retarded 
mental development may readily be traced to a brain lacking 
a sufficient supply of well-oxygenated blood. Who may say 
that if C. G., who to-day clearly belongs to the defective class, 
due to pathologically retarded development, would have ob- 
tained, in early childhood, the needed care resulting in the es- 
tablishment of proper mouth conditions, his mental develop- 
ment would not be a much simpler problem than it now is? 

Whether in a condition as aggravated as his, and at an age 
as advanced as his, great beneficial results could be derived 
from remedying, to such an extent as would be possible, his 
oral defects, is not altogether certain. But from past experi- 
ences the attempt is warranted. 

In another case, the one of D. T., Case 65, 18 years old 
(Figs. 53 and 54), male, there are perhaps prenatal causes work- 
ing along with the postnatal causes. The one important fac- 
tor always assisting normal jaw-bone development — I refer to 
breast-feeding — being reported positive in D. T.'s clinical his- 
tory, the underdeveloped maxilla and mandible can be accounted 
for either as an inheritance, or as the result of prolonged exist- 
ence of adenoids and enlarged tonsils. These were not removed 
until the age of 10, which means that mouth breathing was 
allowed to interfere with proper respiration during the period 
of jaw-bone growth. 

Mouth Breathing. — Breathing through the mouth instead 
of through the nose changes the normal action of the muscles 
controlling the position of the lips, and changes the position of 
the tongue, which, when the mouth is in repose, in normal breath- 
ing, rests flat against the roof of the mouth, thereby contributing 
mechanically to a lateral development of the maxillary bones. 
When in breathing the mouth is kept open, instead of closed, 
as it should be, the upper lip is drawn upward, depressing the 
subnasal anterior portion of the maxillary bones, contributing 
to underdevelopment of these parts, which accounts for the orig- 
inal crowded condition of the upper anterior teeth of D. T. 

The unfortunate remedy resorted to, in this case, in the de- 
sire to cope with this condition, namely, the extraction of the 
right and left upper cuspids, presumably for the purpose of 



A MEDICAL SYMPOSIUM 587 

making room, has resulted in further narrowing of the upper 
arch and in further crowding of the lower teeth, in a mandible 
already much underdeveloped. 

It would be indeed interesting to see to what extent the ex- 
panding of both the maxilla and mandible would improve 
D. T.'s mental faculties, as undoubtedly the remedying of these 
conditions will have as immediate result the bettering of the 
brain pabulum quality. 

Bottle-Feeding. — In D. L.'s case, Case 78, 14 years old, 
male (Figs. 55 and 56), the general clinical history reports 
alongside of similar causes, as in the previous case, the one 
other most important factor responsible for lack of jaw devel- 
opment — I am now referring to bottle-feeding — which was in- 
flicted upon this child for two years. 

The maxillary protrusion, the complete lack of anterior oc- 
clusion, and the faulty posterior occlusion might have all been 
prevented if adenoids and tonsils had been removed in their 
incipiency. They were removed after the completion of the 
jaw-bone development. In addition to the enumerated defects 
from underdevelopment, defects from sheer negligence have 
operated their evil sequelae in D. L.'s mouth. Caries were 
allowed to destroy almost to the roots two of the four most im- 
portant teeth in the mouth, the first permanent molars. The 
reported premature extraction of deciduous teeth had its share 
in causing the crowded condition of the permanent teeth in his 
mouth. 

With all these causes present, interfering on one hand with 
proper mastication, on the other with proper respiration, is it 
surprising that underweight is reported, that the general physical 
condition is stated as poor; and would it be surprising that in 
giving due attention to D. L.'s teeth and correcting his mal- 
occlusion, a bettering of his physical condition would be obtained, 
and will this not materially contribute to raise D. L.'s mental 
status? 

Other Cases. — The casts of E. K., Case 79, age 14, female 
(Figs. 57 and 58), show again every indication corroborating the 
facts pointed out in the cases enumerated above. 

There are, in the general history of this case, prenatal as well 
as postnatal findings reported. The maternal grandmother 
had pulmonary tuberculosis, the mother is reported as a very 



588 APPENDIX 

nervous woman, and E. K. herself has had her troubles from 
birth on, almost all through her life, but was fortunate in bene- 
fiting by one advantage, breast-feeding; and were it not that 
adenoids and tonsils were allowed to interfere with her nasal 
respiration, she might have developed normal jaw-bones. As 
it is, she has a pronounced maxillary protrusion, both the 
maxilla and mandible being constricted and needing expansion. 

I need not repeat that on account of the condition caused by 
leaving adenoids and tonsils undisturbed until the age of 13, 
the advantage for jaw-bone development gained through breast- 
feeding was entirely lost, mouth breathing taking place. 

For more than one reason, E. K. rightly belongs in the atypical 
class, and it can only be said that hers is another case where 
an improperly nourished brain, due partly to improper breathing, 
contributes to the difficulty of solving the problem of this ex- 
ceptional child. 

In H. H., Case 80, 9 years old, female (Figs. 59 and 60), 
is found marked corroboration of the contention that early re- 
moval of adenoids checks the nefarious influence which their 
existence has upon jaw-bone development. Her clinical history 
reports that beginning with the initial handicap, bottle-feeding, 
she goes through whooping-cough, measles, is twice left listless 
and feverish for three days from falling; had inco-ordination of 
posture and gait, walking sometimes on hands and knees up 
and down stairs; digestion is retarded; has bad fits of temper, 
throwing herself on the floor, kicking and screaming; is gaining 
poorly in weight, and her heart does not seem strong. With all 
this, H. H. is reported to be bright in school work, and rather 
beyond her age in school accomplishments. 

When, as in this case, the clinical history points to such 
positive findings of serious nervous disturbances which naturally 
would interfere with general development, and in spite of it 
the jaw-bones have developed almost normally, seeing that the 
mesio-distal relation of the first permanent molars is normal, 
and only a slight tendency to maxillary protrusion is present, 
what accounts for it? The bottle-feeding has worked its initial 
evil influence resulting in this just-mentioned slight maxillary pro- 
trusion, but this has not progressed very far, the mouth breath- 
ing resulting from adenoids having been checked through their 
early removal, once at the age of 4, and again at the age of 5. 



A MEDICAL SYMPOSIUM 589 

Perhaps a still earlier removal of the adenoids would have shown 
its beneficial effects in a still slighter progress of the maxillary 
protrusion. However, the condition obtained was sufficient to 
allow a proper respiration, and does it not seem as if, this hav- 
ing contributed to a flow of well-oxygenated blood-supply to 
the brain, it has kept the mental faculties of H. H. above her 
physical status? Does it not appear clearly that a better res- 
piration was obtained through checking the progress of the 
maxillary protrusion and its consequences? 

Again, in this same case, are found several decayed teeth, 
and some inadequately filled teeth. And again, the clinical 
history reports: " Digestion was normal, but recently is retarded 
and seems to point to fecal poisoning, which may be at the bottom 
of much of her seemingly nervous trouble." It is quite likely 
that the digestion was normal, and that with the progress of the 
decaying of her teeth, to the extent that proper mastication 
is interfered with, the digestion suffers, and if this be the direct 
cause of her " nervous troubles," may they not be remedied by 
giving due attention to her teeth, re-establishing thereby proper 
mastication and normal digestion? 

Would the elimination of the sources of H. H.'s " nervous 
troubles," i. e., the fecal poisoning from retarded digestion, not 
be a potent factor in avoiding the danger of her sliding into the 
subnormal type ? Would it not, perhaps, even help her to glide 
with facility through the atypical class into the typical? 

I now take up the case of M. A., Case 81, 14 years old, 
male (Figs. 61 and 62), and comparing his general clinical his- 
tory with his casts, I find my observations along these lines 
substantiated more than in other cases I have yet seen. 

The anterior occlusion, the mesio-distal relation of the right 
first molars and with it the posterior occlusion of the right half 
of M. A.'s mouth are almost normal with the exception of the 
inlocked upper right cuspid. 

Were it not for this and for the unfortunate error of having 
his upper left first molar extracted, which caused the lower left 
second molar to erupt out of alignment, M. A. could have boasted 
of absolutely perfect occlusion. Why? 

His general clinical history reports that up to the age of 7 
his physical condition was normal; he was not a mouth breather, 
he had neither tonsils nor adenoids, and last but not least, he 



590 APPENDIX 

was breast-fed. In one word, he passed through the develop- 
mental stage of jaw-bone growth without any handicaps. 

M. A. is undoubtedly one of the cases where the causes for 
a stunted mental development are to be looked for elsewhere, 
not in the mouth; and when these causes are looked into, it is 
found that while they have influenced brain development, their 
occurring later in childhood, after the age of 7, have left un- 
touched the facial expression of M. A., which in spite of his 
unfortunate mental status presents an intelligent appearance. 
The proper jaw-bone development and the contributing of it 
to the proper development of the rest of the bones of the face 
has blessed him with at least one handicap less. From a psy- 
chical standpoint, a pleasant exterior is perhaps no small factor 
contributing to overcome the difficulties with which the excep- 
tional child has to count in the world. 

The six illustrated cases were taken from among a number 
of about twenty children examined and observed at Herbart 
Hall, in Plainfield, N. J. 



VII. HABITUAL CONSTIPATION 1 

By Doctor B. Onuf, Park Ridge, N. J. 

Constipation and Exercise. — How often is the neurotic, who 
is so frequently subject to habitual constipation, directed to 
take much exercise! Careful observation teaches, however, 
how ineffective or sometimes even harmful such a direction can 
be if not taken in the right sense. The exercise in itself, be it 
walking or gymnastics, bicycling or bowling, etc., is not at all 
conducive to repairing the disturbed intestinal function under- 
lying the constipation. In the cases in which it is of any use 
the improvement is not caused by the exercise itself but by the 
accompanying mental relaxation. Without this psychic re- 
laxation all exercise is useless. The intestinal function requires, 
so to say, a certain amount of mind for its successful performance, 
and has to suffer when deprived of the same. If the mind is 

1 This contribution is part of a paper published by Doctor Onuf under the title 
"Psychotherapy," in the Journal of the American Medical Association of June 
6, 1908, and is here reprinted in modified form by permission of the author as 
being of great value for the physical welfare of children. 



A MEDICAL SYMPOSIUM 591 

occupied by a certain train of thought to the exclusion of every- 
thing else, there is nothing left of it for the intestine. 

In such cases exercise may be directly harmful, the patient 
needing at times complete physical and psychic rest instead. 
Lying on a couch for half an hour will then benefit him more 
than a long walk or other physical exercise. 

The above deductions find, in a certain sense, an interesting 
confirmation in the investigation carried on by Doctor Joseph 
Merzbach. This author made inquiries from 233 letter-carriers, 
243 policemen, and 102 office clerks in regard to the movements 
of their bowels. This clinical material represented therefore 
occupations with excessive, moderate, and little bodily exercise, 
respectively. His conclusions, expressed with a certain re- 
serve, it is true, were these: " Rest and ordinary exercise, but 
not excessive exercise, are equivalent in their functional results. 
Violent exercise certainly contains a factor influencing peristalsis, 
but this influence is more frequently in the direction of inhibi- 
tion rather than in that of stimulation. Rest acts least favorably 
(i. e., in the smallest percentage of cases), but also much less 
unfavorably than moderate and excessive exercise." 

Mental Attitude in Defecation. — Of great importance is also 
the attitude during defecation. In this act, too, the intestine 
requires a certain participation of mind for securing proper 
function. Defecation is only to a small extent an act of the will, 
but is in a large part dependent on peristalsis, which cannot be 
influenced by the will. Pressure movements, if not made at 
the right moment, are therefore not only unsuccessful to the 
immediate result, but even detrimental to the final result 
through the discouragement which the inefficiency causes. 
The action of mind must restrict itself to paying attention to 
the intestinal stimuli and yielding to them. This is accom- 
plished chiefly through the relaxation of the sphincter and 
usually results in the discharge of gases which facilitates a 
further movement of the fecal mass. In this way, conscious- 
ness supports indirectly the peristaltic movement of the intes- 
tine which it cannot influence directly. For this reason the 
patient needs not feel discouraged when the result of his efforts 
is only a discharge of gases and no defecation, for the movement 
of the fecal mass has been furthered by this action, and his next 
attempt is apt to be successful, i. e., to produce stool, especially 



5D2 APPENDIX 

if the patient will, as I would recommend, make two attempts 
daily at defecation. If one does not take his time about it, 
and fails to heed the intestinal stimuli, being taken up with other 
matters, and is anxious to get through quickly, the above- 
mentioned intestinal stimuli will often fail to appear, or rather 
they are psychically suppressed, crowded out by the predomi- 
nance of other contents of consciousness. Furthermore, the at- 
tention is too much diverted to react properly, and thus the 
effect is frustrated. 

The Psychic Factor. — This does, of course, not exhaust the 
subject of habitual constipation. It was only my intention to 
emphasize the importance of the psychic factor in the treat- 
ment of such conditions, and, in closing, to draw attention to 
the brilliant results achieved in many cases by a purely psychic 
treatment, of which fact Dubois's experience gives most eloquent 
evidence. 

VIII. DEFORMITIES IN CHILDREN 

By Doctor E. H. Arnold, New Haven, Conn. 

Classification. — Deformities in children are: A. Congenital; 
B. Acquired. 

A . Under the congenital deformities those that show hereditary 
traits are in a sense the more consequential, since they are apt 
to recur in a family. A type of such deformity is polydactylism. 
Congenital hereditary clubfoot is not particularly rare. In these 
cases the tendency to deform attaches to the primary germ-cell. 
A variety of hereditary deformities which need not necessarily 
repeat in a family is the atavistic deformity. As an example of 
this we have the cervical rib. This is not infrequent in children, 
and may give rise to no symptoms during childhood and youth; 
but as the normal skeleton has completed its growth, growth 
seems to start in these ribs and they may then grow to quite 
the size of an adult rib, causing pressure on the nerves and large 
blood-vessels in their neighborhood. The symptoms from such 
pressure are usually felt first in the arms. 

B. Acquired deformities occur as (i) Weight Deformities; 
(2) Contractures. 

(1) Weight deformities : If superincumbent weight is faultily 
distributed, the bones supporting such weight will be deformed. 



A MEDICAL SYMPOSIUM 593 

If the bones supporting this weight be diseased, the chances for 
establishment of deformity are, of course, greater and the de- 
formity is apt to be graver in degree. Unsound bony tissue 
may deform, however, even under proper amount and properly 
distributed weight. In looking for a causative agent in im- 
properly distributed weight, we find that they may be (a) static, 
(b) habitual, and (c) vestimentary. The terms explain them- 
selves. One leg considerably shorter than the other may make 
so much tilting necessary that a lateral curvature of the spine 
may readily be necessary to throw the weight of the upper part 
of the body so as to bring the centre of gravity within the base 
of support. Quite a percentage of lateral curvatures, however, 
have been properly attributed to bad habits of distributing 
weight in standing or sitting. Faulty sitting posture in poorly 
devised and adjusted school seats has been held responsible 
for the establishment of bad sitting habits. One of the most 
frequent forms of deformities caused by clothing is the de- 
formity of the chest due to wearing ill-fitting corsets. Much 
more frequent still are the deformities of the feet due to poorly 
constructed shoes. 

(2) Contractures, as the name would imply, are shortenings 
of the soft tissues. Quite a variety of these are met with. We 
have here: 

(a) Skin contractures in consequence of extensive scarring, es- 
pecially after burns. 

(b) Connective-tissue contractures, such as the contraction of 
tissue around the joints after inflammation of a rheumatic 
character, the contraction of the tissue around veins, etc. 

(c) Muscular contractures. These are fairly rare. In one 
variety the muscle contracts primarily after injuries. Much 
more frequent are the second great muscular contractions or 
shortenings that become established as a consequence of paralysis 
of some standing. In this category belong the contractures of 
apoplectic paralysis, also those of infantile paralysis. Naturally, 
the latter variety will have its greatest toll among children. 

(d) Contractures due to disturbances of the nervous organs. 
Under this heading we recognize reflex, spastic, and paralytic 
contractures. 

Under the heading of reflex contractures we have faulty reflexes 
of the several special senses; for instance: great difference of 



594 APPENDIX 

sight in the two eyes, great difference of hearing in the two 
ears may readily bring about, as a reflex, a habitual bad posture 
of the head which will ultimately end in a contracture of the 
soft tissue, being an example of a habitual weight deformity 
ending in a contracture which we shall see hereafter is quite 
frequently an outcome of the conditions. 

Spastic contractures may be the consequence of peripheral or 
central nervous disturbances. Under the second heading we 
find spinal and cerebral spasms responsible for contractures. 

The paralytic kind likewise presents the spinal and cerebral 
varieties. 

Etiology. — The classification given above carries in a large 
measure an account of the etiology of deformities. A word 
may, however, not be amiss about the etiology of those weight 
deformities that come to exist from unsound bone tissue. Two 
of the etiological factors are important by their frequency. 

The first one is rickets, a disorder becoming more and more 
prevalent in the United States, where it was formerly a rarity, 
except in the very largest centres of population. It is largely 
a matter of artificial feeding of infants, poor oxygenation of 
blood by living in crowded quarters, and the lack of sunshine. 
Fortunately, most of the rickety deformities are inconsequential. 
They have a tendency to cure out spontaneously in the cases 
which are milder in form and shorter in duration. On the other 
hand, dwarfing and microcephalus occurring in consequence of 
rickets present the severer degrees of the sequelae of this dis- 
order. 

The other frequent cause of unsound bony tissue is tuber- 
culosis. It would be " carrying coals to Newcastle " to speak of 
the frequency or the cause of tuberculosis in these days. Bone 
tuberculosis presents all degrees of severity, from the lightest 
that pass over without any deformity or loss of function even 
without treatment, to those that will go to appalling degrees 
of deformity in spite of the best of treatment. Bone tuber- 
culosis, like rickets, is especially a disease of early childhood, the 
classical age being between 3 and 4. The most sinister out- 
come in bone tuberculosis is presented by the fact that though 
comparatively few people fall victims directly to the onslaught 
of bone tuberculosis, a great many succumb to intercurrent 
diseases, for in a series of people of advanced age, 50 to 60 and 



A MEDICAL SYMPOSIUM 595 

more years, one will find a very small percentage indeed of people 
with tubercular deformity. 

Diagnosis. — The diagnosis of existing deformity can be made 
by a layman. To diagnose deformity before it becomes firmly 
established must be the most desirable way in approaching the 
problem of deformity. The treatment of deformity can only 
be instituted intelligently if the etiological factor is known. 
For unless we remove the cause, a good many of the deformities 
show a most pertinacious tendency to recurrence. It is not 
always easy to establish the fact whether we are dealing with a 
weight deformity or a contracture, since weight deformity of 
long standing will have secondary contractures as a necessary 
consequence; and it is equally true that contractures of long 
standing will bring about weight deformities. In order to treat 
to the best effect, the sequence of events and the etiological fac- 
tor operating in bringing the deformity to the degree which it 
presents at examination must be known. In the last instance, 
a differential diagnosis is important for a proper prognosis. 

Treatment. — The treatment of deformities is general and 
special. 

The general treatment is that of good hygiene and sanitation 
as a preventive measure. The deformity established, general 
treatment is largely symptomatic. 

Special treatment is preventive as well as treatment of the 
actual deformity. Congenital deformities do not lend them- 
selves to preventive measures in any degree; but acquired de- 
formities are practically all preventable. In the last instances, 
rickets, tuberculosis, infantile paralysis, which form such a large 
quota of acquired deformities, are certainly preventable. Static 
weight deformity, habitual weight deformity, and vestimentary 
ones with sound tissue are practically all preventable. Even a 
great many of the spastic paralyses are preventable as far as 
they rest upon syphilitic ground, or upon trauma to the skull 
at birth. A vigorous campaign of education against the above- 
cited causative agents of deformity will certainly make them 
diminish in numbers. The deformities once established can be 
reached by local treatment, which may be mechanical or surgical. 

Under the mechanical treatment, treatment by massage, pas- 
sive and active exercise, as well as retentive apparatus and 
braces are all of great use. 



596 APPENDIX 

The surgical treatment of deformities has made great strides 
forward in the last decade. The reclaiming of overloaded 
muscle by proper brace support, the prevention of paralytic 
deformities by brace, have been followed by tendon and muscle 
transplantation, by silk tendon and silk ligaments (intra- and 
extra-articular). Osteoplastic operations on joints, osteotomy 
on bone shafts, arthrodesis on flail joints have all proved their 
value in given cases. To these has been added bone-grafting, 
which has a large field of usefulness in the relief of deformity. 
Decompression for the relief of cerebral spastic paralysis, the 
cutting of the sensory spinal nerve roots for spinal spastic paral- 
ysis, have had some brilliant results in the treatment of these 
otherwise intractable and distressing conditions. 

It is for the orthopedic surgeon to weigh off which one of these 
procedures is to be used at certain stages of deformity. Sur- 
gical procedure is becoming so complex that orthopedic surgery 
has come to be recognized as a special branch of surgery, and 
its mission is mainly the choosing of proper means of treatment 
at the proper time. 

In the prevention and treatment of deformities, it is evident 
the home, the school, and the orthopedic expert must co-operate. 
Early clinical diagnosis is essential. 



IX. THE ROLE OP NEUROMUSCULAR EDUCATION 
IN TRAINING ATYPICAL CHILDREN 

By Doctor C. Ward Crampton, New York City 

Three Parts of Conscious Reaction. — An atypical child is 
deficient or exceptional in one of the three parts of conscious 
reaction to environmental necessities. First, he may be actually 
deficient in some one or all of his sense-perceptions. The rate 
of percept reception may be either too slow or too rapid. Next, 
the sense-perception once received may fall upon a mental equip- 
ment which is either intrinsically lacking in receptive abilities, 
or too dull, untrained, or unalert to successfully incorporate 
the percept with proper relation to previous knowledge; third, 
the apperceptive mass may be too busy with internal affairs, 
or lacking in ability to discriminate and assort, to receive im- 
pressions from a hyperesthetic sense-mechanism. Further, 



A MEDICAL SYMPOSIUM 597 

either too dull or too nervous a mind will be relatively devoid 
of memory images or previously received sense-perceptions, 
and we have an account of too high or too low a nervous po- 
tential, a failure of the perceptiveness to adequately incorporate 
the new stimulus within itself. 

Handicap of Habits. — With these possibilities of deficiency 
in the receptive process, deliberative habits which might lead 
to proper kinetic response are severely handicapped, and there 
results either no action at all, or an inappropriate, inadequate 
motor expression. With these points clearly in mind, the com- 
mon practice of finding fault with children because their 
behavior is inappropriate, assumes a deeper significance than 
formerly. It is comparatively useless to find fault with inaccu- 
rate and inco-ordinated moods and expressions of personality. 

Processes of Dealing with the Handicaps. — In dealing with 
crippled minds it is best to follow the principle which this de- 
partment 1 has used in dealing with crippled or defective bodies, 
i. e., blind, deaf, tubercular, and crippled, and to develop the 
powers that exist in the hope of developing their processes to 
overshadow unremediable deficiencies. In a mind where cer- 
tain faculties are left out, this course should be pursued. For 
a mind whose processes are weak or faulty in speed, much can 
be done by persistently and intelligently training in simple 
motor problems. 

Process i: Strengthening Weak Powers. — For the inert, un- 
responsive child apparently unable to exercise volition, simple 
passive movements accompanied by the gymnastic command 
should first be used. For instance, the teacher commands: 
" Raise the arms!" and herself moves the arms of the child. 
This is followed by a command similarly executed: " Lower 
the arms! " This may be done slowly not more than eight times, 
but may be repeated thrice within twenty minutes. After a 
sufficient practice, the child may be made to get the appropri- 
ate response with the passive movement. The teacher may in- 
dicate the movement herself without touching the child. This 
method should then be extended to other movements. By this 
process the powers of reception, deliberation, and volition are 
gradually awakened if they exist potentially in any degree 

1 Department of Physical Training, New York Public Schools. 



598 APPENDIX 

whatsoever. Upon this basis, all kinds of instruction in any 
appropriate field whatsoever may be set forward. 

Process 2: Objective-Subjective Methods. — It will be found 
that many atypical 1 children are able to do various simple 
natural movements which have some purpose. They are un- 
conscious of any volition in connection with them. These move- 
ments may be used to establish the process of learning and of 
conscious subjective volition, the highest and usually the weak- 
est of all mental processes. Take, for instance, walking, which 
most children can accomplish without difficulty. The teacher 
gives instructions to walk to the front of the room, pick up 
something and return to the seat; next to walk around the room 
and in order up and down the aisles, and to various places and 
return, always commending accuracy, and gently criticising 
failure. Variations in rate should follow, and variations in 
length of step may be undertaken. Next, there should be in- 
troduced jumping, skipping, and the like. Arm movements 
may then follow in combination; first the arms may be extended 
sideways, then moved up and down as if flying. Next, move- 
ments of the arms should be undertaken in the same rhythm 
as the walking. The greatest care should be taken not to make 
progress too rapidly and earlier lessons should be reviewed step 
by step. 

The next step should be the correlation of the external and the 
internal rhythm. For this purpose the phonograph provides the 
most excellent means. The simple marches and waltzes with a 
most decided and emphatic rhythm should be used. The whole 
process should begin again with simple walking, and elaboration 
may be made in a manner above indicated. It is of great profit 
to introduce some of the simpler folk-dances which are appro- 
priate for normal children of 6 to 8 years. Some of these 
have a song in connection with them, and this provides an ad- 
mirable method of awakening the whole child to a co-ordinated 
mental and physical activity. The results which have been 
derived from this process are astonishing. Minds apparently 
hopelessly lacking in reception, deliberation, and volition have 
disclosed their hidden abilities, and others too dull or too active 
for accurate co-ordination have adjusted their modes of combined 

1 Doctor Crampton does not use this term precisely in the sense of the 
author's terminology. 



A MEDICAL SYMPOSIUM 599 

action to each other with a beautifully smooth and natural ter- 
minal product of normal child activity. 

As a last term in the series of subjective-objective motor 
problems, and as an item of daily motor practice for pupils in 
process of training, the simple folk-dance has an undoubted 
value and a peculiar significance. It is a form of whole-child 
activity which has been practised spontaneously by hundreds 
of generations of children; only the most appropriate forms 
have survived, and these are the ones that have passed the 
great human test of child choice. They are of tremendous 
biological significance, and when learned and practised they 
bring children into a realm of normal human activities from 
which their deficiencies have previously barred them. To de- 
velop the ability to practise them is indeed a wholesome gift 
to these children, and upon this solid basis a normalized struc- 
ture of mental activity may often be successfully raised. 

X. THE INFLUENCE OF BREATHING AND SPEECH 
UPON THE CHILD'S MENTALITY 

By Otto Glogau, M.D., New York 

Speech and Breathing. — In comparison with speech, breathing 
is a rather low function, met with in both plants and animals. 
Through it, exhaust substances of the body are exchanged by 
fresh chemical elements of the surrounding medium. Speech, 
the expression of thought, is the exclusive privilege of the human 
race. It serves the exchange of mental fluidum between human 
souls. There exists, however, an intimate relationship between 
the physical process of breathing and the psychic, complex act 
of speaking. We shall endeavor to reveal the influence exerted 
upon the child's mind by disturbances of breathing and of speech. 

As the brain matter is the organic substratum for every 
psychic manifestation, the latter will deviate more or less from 
the norm when the former is insufficiently nourished. The 
mechanical hindrances which affect breathing interfere with the 
normal oxygenation of the blood, and thus produce an under- 
nourishment of the sensitive brain tissues. In nasal obstruc- 



600 APPENDIX 

tion, whether due to hypertrophied turbinates, deviation of the 
nasal septum, or enlarged adenoids, the child is forced to breathe 
through the mouth. Thereby the air reaches the sensitive 
alveoli of the lungs in a cold, dry, and dirty condition. By 
passing through the nose, the air would have been priorily 
warmed, moistened, and purified by the vascular activity of the 
nasal turbinates. The insufficient supply of air produces a 
variety of symptoms, such as headaches, lassitude, inability to 
study or to do anything requiring mental concentration. The 
mechanical nasal obstructions interfere with the aeration of 
the Eustachian tube, the channel between the nose and the ear. 
The middle ear will dry out, and will easily become infected. 
The catarrhal and suppurative processes of the middle ear 
cause impaired hearing. Thus the acquisition of normal speech 
and consequently a normal mentality are interfered with. 

Faulty Breathing. — Faulty breathing, accompanied by mental 
abnormalities, occurs, however, even with perfectly normal air 
passages. For breath is not only the oxygen-carrier for the body, 
it provides also the propelling power for speech. Normal speech 
depends upon the mastering of the difficult art of correct breath- 
ing. To facilitate matters, we shall term the process of breathing 
that serves exclusively the conservation of the organism as 
" animal breathing." We differentiate it thereby from the 
type of breathing that is employed during articulate speech, and 
term the latter as " articulatory breathing." 

Mechanism of Respiration. — The mechanism of respiration 
is as follows: the flattening and downward movement of the 
diaphragm and the rising and expansion of the ribs widen the 
thorax. The lungs, during this act of inspiration, passively fol- 
low the expansion of the thorax and diaphragm. The recoil- 
ing elasticity of the ribs and lungs induces, without any mus- 
cular activity, the expiratory movement. Flourens assumed 
within the medulla oblongata a regulating respiratory centre, 
wherefrom impulses are supposed to emanate down to the 
branches of the respiratory muscles within the spinal cord. 
Recent experiments on animals, especially those made by Jacques 
Loeb, prove, however, that in animal breathing the assumption 
of a regulating centre is not necessary. 

The structural peculiarity of segmentation met with in the 
low animal forms exists even in the highest developmental stage. 



A MEDICAL SYMPOSIUM 601 

Each segment is dominated by a ganglion wherein reactive 
powers of both the sensory and motor nerves are stored. By 
very painstaking experiments on Limulus, Loeb proved that 
if the whole central nervous system with the exception of these 
ganglia be removed, the rhythmical respiratory activity con : 
tinues unchanged. He also proved that every ganglion is the 
seat of an automatic periodic activity. He says: 

In higher animals, the conditions controlling respiration scarcely 
differ from those in Limulus. There is a series of segmental ganglia 
in the thoracic portion of the spinal cord which sends nerves to the 
thoracic respiratory muscles of the respective segments. Chemical 
changes which are continually going on in the body, or in these seg- 
mental ganglia, under the influence of heat (the temperature of the body) 
produce a periodic activity in these ganglia and consequently in the 
respiratory muscles. The segmental connection existing between the 
ganglia and the muscles would bring about co-ordination just as it does 
in Limulus. 

Human Breathing a Reflex Action. — Basing on these and other 
experiments, we assume that animal breathing in the human 
being is also a segmental function, and as such a reflex action. 
We believe that animal breathing is localized within the ganglion- 
cells of the motor-nerve roots of the respiratory muscles. The 
ganglion-cells of the different spinal segments are connected with 
one another by fibres whereby cells of different levels may be 
stimulated by the sensory irritation of ganglion-cells below and 
above their location. From the ganglion-cells of the different 
motor horns of the respiratory muscles, numerous conductive 
fibres also go upward toward the medulla oblongata, and form 
a connection with the nuclei of the speech muscles. Another 
set of conductive fibres go from the respiratory ganglion-cells 
through the medulla oblongata up to the brain. These fibres 
are, however, centrifugal. They originate in what we call the 
articulo-respiratory centre. 

Inarticulate Sounds Also Reflex in Nature. — It is a fact that 
crowing, quacking, etc., animals continue to utter their inartic- 
ulate sounds even after their brain has been removed up to the 
corpora quadrigemina. Children born without a brain (anen- 
cephalics), and children whose brain has been destroyed during 
delivery, are still producing crying or whistling sounds. These 



602 APPENDIX 

facts induced Kussmaul to localize the centre for inarticulate 
sounds behind the corpora quadrigemina. Believing that the 
formation of articulate sounds depends upon the integrity of 
this centre, Kussmaul called it the basal sound centre. 

It is our assumption that there does not exist such a thing as 
a centre for inarticulate sounds. Within the medulla oblongata 
originate all motor nerves of the head, and terminate all sensory 
head nerves, including those of the muscles of speech. In ad- 
dition to the interlacing of the nuclei within the medulla oblon- 
gata, by numerous connecting fibres, we assume that they are 
connected by special conductive paths with the ganglion-cells 
of the motor-nerve roots of the segmental respiratory muscles. 
In this way a reflex arc is established between breathing and the 
uttering of inarticulate sounds. 

The first cry the new-born baby utters is nothing but a reflex 
stimulation of the nuclei of the vocal and articulatory move- 
ment; the sensory part of the reflex arc is the external irritation 
(lowered temperature and changed skin sensation) which simul- 
taneously causes the first breath. 

Both animal breathing and the uttering of inarticulate sounds 
can therefore be easily explained as reflexes without the assump- 
tion of any regulating centres. 

Breathing and Articulate Speech. — We will now describe the 
changes in the type of breathing that occur when the uttering 
of inarticulate sounds develops into the articulate language of 
the human race. Suffice it to state that the articulatory move- 
ments of the first babbling sounds are reflex impulses that may 
be compared to the inco-ordinate movements of the baby's little 
hands and feet preliminary to the mastering of the arts of grasp- 
ing and walking. 

Through the aid of the senses of hearing, vision, and touch, 
assisted also by the muscular sense, the baby first learns to 
copy and repeat his own (primitive) sounds and gradually also 
those constantly repeated by the surrounding persons. Thus, 
through continuous training, first the mechanical, and gradually 
the psychic side of speech is learned. 

In producing the above-mentioned primitive babbling sounds, 
there is not only deposited within the brain a picture of the posi- 
tion and tension of the articulatory muscles, but also a reminis- 
cence of the power of breath passing by these gateways of speech 



A MEDICAL SYMPOSIUM 603 

during the utterance of sound. The first consonants the baby- 
uses are " p " and " t." The first words are " papa " or " tata." 
In order to pronounce the "p," it is not enough to press the 
lips upon one another and to open them. It needs an air- 
current of a definite power to explode the closing of the lips so 
that the sound of "p" may be heard. The same holds good for 
the other "occlusives," "fricatives," etc., where the air-current 
has either to push open a closed portal or to rush through a 
narrow one. 

Language Centres. — The centres for language as recognized 
up till now may be divided into two types, sensory and motor, 
and are as follows: 

First: a centre for the reception of the memories of spoken 
words; 

Second: a centre for the reception of the memories of the 
appearance of objects as seen, and of words as written; 

Third: a centre for the reception of the appearance of objects 
gained through the sense of touch; 

Fourth: a centre for the memory of the muscular movements 
necessary for the performance of articulate speech; 

Fifth: a centre for the memory of muscular movements con- 
cerned in writing. 

The hitherto acknowledged centres of speech are, however, 
not adequate for the explanation of the entire process of articu- 
lation. We must assume the existence of an " articulo-respira- 
tory centre " within the cortex of the brain. Within the " articulo- 
respiratory centre" there is deposited the memory of the action 
of the respiratory muscles during articulation. The articulo- 
respiratory word-picture thus obtained is due to the centripetal 
impulses originating from the sensory nerves of the lungs and 
the respiratory muscles. The exact state of the respiratory 
tract and the respiratory muscles during the production of the 
particular power of breath essential to the articulation of the 
respective word is thus, so to say, registered within the articulo- 
respiratory centre. The centrifugal pathway from the articulo- 
respiratory centre is formed by the innumerable conductive 
fibres between it and the ganglion-cells of the respiratory mus- 
cles within the spinal cord. If we now add the articulo-respira- 
tory centre to the above-mentioned centres of speech, the process 
of speech will take place as follows: 



604 APPENDIX 

Process of Speech. — Assuming that the impulse to articulate 
a certain word has arisen within the transcortex, the "throne 
of reason and thought," it will be immediately carried to the 
different centres. The abstract idea of the word will thus be- 
come invested with all the material qualities of its object. The 
strongest impulses, however, will be imparted where the memories 
of the articulated word are deposited, viz., of its sound-picture, 
of the muscular activities during articulation, and of the articulo- 
respiratory power during its articulation. 

These three centres, by means of intricate, associative fibres, 
stimulate one another and thereby enhance the co-ordination 
of their activity. The sensory speech centre seems to be the 
most vibrating one. _ The memory of the sound of the word to 
be articulated rises nearer to the surface of consciousness than 
that of its muscular and articulo-respiratory peculiarities. The 
impulses are then conducted from the motor speech centre to the 
cortical area of the speech muscles, and thence to their nuclei 
within the medulla oblongata. Simultaneously, the impulses 
from the articulo-respiratory centre travel to the cortical area 
of the respiratory muscles, and from there to their spinal gan- 
glion-cells. While the sound-picture of the word rings upper- 
most in the mind, the speech muscles - are set into the appro- 
priate speech positions, and the articulo-respiratory air-current 
passes by them in the adequate strength. 

From these considerations it becomes evident that any affec- 
tion of the articulo-respiratory centre or its connections with the 
other speech centres will cause more or less marked disturbances 
of speech which, in turn, influence the psychic state of the child 
unfavorably. 

The Psychic Mechanism. — Breathing during speech (articu- 
latory respiration) is a psychic act. In a normal mentality we 
also find a so-called normal type of articulatory respiration. 
This type of breathing will, however, deviate more or less from 
the norm in the atypical, subnormal, and abnormal children, 
as Doctor Groszmann so ably classifies them. Before going 
into detail about the influence of abnormal breathing upon the 
child's mentality, we shall first describe the so-called normal 
type of breathing. 

Normal Breathing. — Breathing during rest (animal breathing) 
is automatic or reflex. Thoracic and abdominal breathing pro- 



A MEDICAL SYMPOSIUM 605 

ceed quite symmetrically. The inspiration is of about the same 
length as the expiration. Only a small volume of air is moved. 
Breathing takes place exclusively through the nose, provided 
there does not exist any nasal obstruction. The vocal cords 
during inspiration and expiration form an oblong triangle. The 
type of breathing as met with during speech differs from the 
former quite considerably. Here the breathing is distinctly 
under the influence of the brain, a so-called voluntary action. 
The thoracical or costal type of breathing prevails. The inspira- 
tion is very short, the expiration very long. Quite a large 
volume of air is moved. During speech, breathing takes place 
exclusively through the mouth. During inspiration, the vocal 
cords form a very large pentagon, in order to admit the on- 
rush of air; during expiration, they form only a very narrow 
slit. 

The Two Types of Breathing. — The difference between the two 
types of breathing can also be demonstrated by certain labora- 
tory methods whereby so-called records of breathing are taken. 
The inspiratory and expiratory movements of the chest and 
abdomen both during rest and during speech are recorded by 
the so-called pneumograph. This instrument consists of a 
closed rubber tube expanded by a spiral spring. The tube has 
at its end a small outlet which is connected by means of a rubber 
tube with a so-called Marey's tambour. The pneumograph is 
fastened around the thorax and abdomen. The expansion and 
contraction of the thorax and the abdomen cause within the 
rubber tube differences of air-pressure that are imparted to the 
thin rubber membrane which covers the metal cap of Marey's 
tambour. To this membrane a very sensitive lever is fastened. 
With the afflux or efflux of air from the pneumograph, the point 
of the lever moves up and down on a rotating recording drum. 
Thereby a white line is registered on the soot of the paper 
stretched around the metal cylinder. The rotation of the latter 
is regulated by clockwork. After obtaining the record, the 
paper (which had been previously smoked over a candle or a 
gas flame) is removed from the metal cylinder and dipped into 
a shellac-alcohol solution. By drying in the air, the record 
becomes fixed. 

Relation of Normal Breathing and Normal Speech. — During 
the past two years I had the opportunity of taking, at the 



606 APPENDIX 

Speech Research Laboratory (Neurological Department, Co- 
lumbia University), numerous breathing records of children 
suffering from various speech disturbances. 1 found deviations 
from the normal type of breathing, often during rest, and always 
during speech, not only in those central speech affections where 
the intellectual development of the child had been interfered 
with (sensory and motor aphasia, congenital deafness, etc.), but 
also in those speech defects where mostly psychic overirrita- 
bility is present (stuttering, stammering, etc.). Due to lack of 
space we shall restrict ourselves to a discussion of the breathing 
abnormalities of the stuttering child. 

The Abnormal Breathing of the Stutterer. — The normal breath- 
ing records show that during rest the waves for inspiration and 
expiration are almost of the same length. During speech, how- 
ever, when we talk on a prolonged expiration, the wave of the 
latter is considerably longer, while the inspiratory wave is im- 
mensely shortened. 

The study of the breathing curve of the stutterer reveals the 
following interesting facts. In lighter cases of stuttering the 
curves in breathing during rest (animal respiration) may appear 
normal. But in quite a number of the more pronounced cases 
of stuttering even the curves of breathing during rest show ir- 
regular elevations, sudden jerks and other deviations from the 
normal curve, such as point to a lack of control over the econ- 
omy of breath. Basing on these findings, the experienced ob- 
server may in many instances diagnose the case as one of stut- 
tering, without the stutterer having spoken even one word. 
During speech (articulatory respiration) the thoracic and ab- 
dominal breathing curves of the stutterer become directly 
pathological or, so to speak, pathognomonic. We find the short 
inspiration and long expiration replaced by an irregular con- 
glomerate of inspiratory and expiratory jerks, by straight lines 
indicating the stoppage of breath, and by asymmetrical un- 
dulations. 

Abnormal Breathing as a Cause of Psychic Disturbance. — 
How are the psychic irritations in the stuttering child produced 
through these abnormalities in breathing ? 

Let us suppose that through any reason whatsoever (trauma, 
fright, shock, infectious disease, etc.) a predisposed child ac- 
quires an affection of the articulo-respiratory centre or of the 



A MEDICAL SYMPOSIUM 607 

fibres connecting it with the other speech centres. This child 
suddenly notices that he is unable to explode the closed lips 
with the strength necessary to articulate the letter " p." The 
same may be noticeable with any other consonant. Of course 
he will try to overcome the obstacle by increasing the air-pres- 
sure from the lungs toward the closed lips. This attempt to 
overcome his articulo-respiratory disturbance, when repeated 
over and over again, finally leads to the tonic and clonic con- 
tractions of the diaphragm and the other respiratory muscles 
which are the cause of the irregularities of the breathing records 
of the stutterer. 

When the attempts to direct an adequate articulo-respiratory 
current of air toward the consonant portals have failed, the 
stutterer will try to bring about the correct articulation of the 
intended consonant by concentrating his attention to the speech 
muscles involved. The contraction of the respective speech 
muscles will gradually tighten and will last longer, whereby, in 
time, so-called tonic cramps will be brought about. If this 
attempt fails, a rapid succession of contractions and relaxations 
of the respective speech muscles will be resorted to, a procedure 
which, through inevitable exaggerations, will finally lead to 
their clonic cramps. At this stage, the psychic effects of the 
described attempts of correcting the faulty articulatory respira- 
tion will become evident. 

"A never-failing symptom is the patient's lack of confidence 
in his ability to speak correctly. In some cases, the mere thought 
' Will I be able to say that word ? ' is sufficient to make it abso- 
lutely impossible for the person to say it. The stutterer always 
lives with the fear that 'his speech may go back on him'; when 
the dreaded word is coming he avoids it by selecting another that 
will serve just as well. The fear of being ridiculous is nearly al- 
ways present, also usually a condition of mental flurry. The 
embarrassment and sad experiences of the stutterer often lead 
to an abnormal mental condition. The patient is nervous, shy, 
easily embarrassed, retiring, odd in his ways, sad, etc. In some 
cases the change does not go beyond an increase of sensitive- 
ness. Many stutterers, especially young women and school- 
boys, acquire a permanent facial expression that is typical of 
the profoundest sadness. The thought of suicide is frequent." 
(Scripture.) 



608 APPENDIX 

Defective Hearing and Speech Troubles. — It is a well-known 
fact that children with impaired hearing, especially those suffer- 
ing from acquired or congenital deafness, show a tendency to 
deteriorate or lose entirely the faculty of speech. Through this 
impaired conceptual ability, these children " may lose their 
normal characteristics and degenerate into permanent defective- 
ness." (Groszmann.) It is interesting to know that in these 
children with defective hearing the type of breathing deviates 
considerably from the normal. In acquired deafness, the pneu- 
mographs curve in mere breathing shows no peculiarities; it 
differs, however, during speech considerably from the normal. 
The inspirations are extremely frequent. The relation between 
the length of inspiration and of expiration also deviates greatly 
from the rule. The deaf child, in comparison with the normal 
child, speaks remarkably few syllables on one breath. Evidently, 
much more power is expended in the articulatory movements, 
as evidenced by the expiratory jerks of the thoracic record. 
This fact causes the characteristic heavy speech of the deaf. 
In a congenitally deaf child the foregoing peculiarities appear 
much more pronounced. The number of inspirations during 
speech exceeds those during mere breathing in an astonishing 
degree. The thoracic breathing curves show an extremely 
ataxic character. The later in life deafness is acquired, the 
more will the breathing curve during speech approach the nor- 
mal. We may diagnose immediately from the breathing curves 
of a deaf child whether his affection is acquired or congenital. 
(Gutzmann.) 

Other Causes of Speech Disturbances. — Disturbances of 
speech may be due to organic causes, such as defects in the 
organs of speech, obstructions to the current of air, etc., or to 
central causes, such as fright, trauma, shock, etc. I agree with 
Doctor Groszmann in classifying the child suffering from an 
organic speech defect as pseudoatypical or atypical, respectively. 
I object, however, to considering a child suffering from a central 
speech defect, even if due to congenital deafness, as " sub- 
normal," per se. 1 I am much pleased to find that Doctor Grosz- 

1 This objection is possibly due to the impression caused by the constant 
abuse of the term "subnormal" as more or less confused with "abnormal." 
The absence of one or more "normal potentials" stamps a child as "subnormal," 
no matter what his intellectual abilities otherwise are. This is clearly shown 
in other chapters of this book. — The Author. 



A MEDICAL SYMPOSIUM 609 

mann, in the newly revised form of his classification, as used in 
this book, has made a distinction between " deaf " and " dumb." 
For every deaf child, by proper instruction, can be taught how 
to talk. 

Correction of Speech Defects. — The results gained from the 
experiments made in the Speech Research Laboratory have 
taught us what the normal type of breathing is, both during rest 
and during speech. It may be assumed that in every case of 
speech defect, causing a disturbance of the normal mentality 
of the child, the type of breathing also deviates from the norm. 

The correction of speech defects, aiming also toward the im- 
provement of the mental qualities of the child, will therefore be 
greatly aided by appropriate breathing exercises. This training 
in the economy of breath will restore the lost control over the 
respiratory muscles. In order to prove successful, the breath- 
ing exercises must be founded on the scientifically established 
facts of the normal physiology of breathing and of speech. 
The improvement in breathing, the "conditio sine qua non" 
for the correction of speech defects, may be easily controlled 
by breathing records taken at regular intervals. Especially in 
the instruction of the stuttering and of the speaking deaf child, 
methodical breathing exercises are of immense aid. With the 
successful progress of the treatment, the breathing records show 
more and more a tendency to return to the normal type. For 
this reason, every clinic where the treatment of speech defects 
and simultaneously a remoulding of the child's mind is under- 
taken, should be aided in its aims by the valuable work of a 
Speech Laboratory. 

It ought to be impressed upon both parents and teachers 
that normal speech and normal breath are the foundation of a 
normal mind. 

The physical impediments to breathing and speech should be 
diagnosed, corrected or removed by the physician. The central 
defects of breathing and of speech should be restored to the 
norm by the speech instructor or by the Speech Clinic, greatly 
aided by the intelligent and sympathetic efforts of the parents 
and the school-teacher. Through this co-operation between 
physician, parents and educator, innumerable children will re- 
gain their mental equilibrium after it had been almost upset by 
their handicap in the expression and reception of thought. 



610 APPENDIX 



XI. THE DEAF CHILD FROM THE STANDPOINT 
OF THE EDUCATOR 

By John Dutton Wright, M.A., New York 1 

Classification. — In the classification of exceptional children 
as adopted in this volume, deaf children would appear under 
each of two primary divisions. Under Division A, they should 
be placed in Subdivision 4 of Group (a) of Section 2: " Impaired 
Hearing." Under Division B, they would come under Section 
1. The term in that section is: " deaf, dumb." 2 

For educational purposes, deaf children who are otherwise 
normal should be divided into four general classes. 

(1) Those with hearing slightly impaired after speech has been 
acquired. 

(2) Those whose hearing has been entirely destroyed, or very 
seriously impaired, after speech has been acquired. 

(3) Those with hearing slightly impaired from birth or early 
infancy. 

(4) Those totally deaf, or with hearing very seriously impaired, 
from birth or early infancy. 

Each of these four groups requires different educational treat- 
ment in order to bring the children most nearly to the educa- 
tional standard of the normal child. The problem grows pro- 



1 This is the only not strictly medical contribution to this chapter; but it 
fills its place most legitimately and will be fully appreciated. — M. P. E. G. 

2 A comma seems a small and insignificant thing, yet its presence after 
the word "deaf" in this place indicates an advanced state of intelligence on 
the part of the creator of this classification. Too often, both by professional 
men and laymen, the term "deaf and dumb" is used indiscriminately to describe 
the speaking deaf and those who have never learned to speak. Unfortunately, 
there are "deaf and dumb" persons. But there are thousands of persons who, 
though born deaf, are not dumb, since they have been taught to speak. There 
are also persons who are dumb, but not deaf, their dumbness being due to 
some malformation of the organs of speech, or to some mental defect. 

The author of this classification has very cleverly indicated these facts, and 
avoided the absurd nomenclature too often employed, by the simple device 
of inserting a comma after the word deaf, thus providing a category for the 
speaking deaf, and showing that he knows that dumbness is not necessarily an 
accompaniment of even total congenital deafness. As a matter of fact, deaf 
children of normal intellect who are given proper educational treatment do not 
grow up dumb. — J. D. W. 



A MEDICAL SYMPOSIUM 611 

gressively difficult from the first group to the fourth, in which 
last very special skill and experience are required to even ap- 
proximate the normal. 

Effect of Impairment of the Auditory Sense. — Even slight 
impairment of hearing in a child is a far more serious handicap 
than a considerable degree of deafness in an adult, since it is 
very largely through the hearing that during childhood we 
acquire our speech and our understanding of language. A de- 
gree of deafness that, occurring in adult years, would not in- 
capacitate a person for the ordinary pursuits of life and general 
social intercourse, would, if it occurred at birth or in early in- 
fancy, prevent the child from learning to speak properly and from 
acquiring language and mental development for which language 
and speech are essential. 

Need of Early Diagnosis. — Every child should, therefore, be 
subjected to very careful observation during the first eighteen 
months, and if there are any indications of even slightly impaired 
hearing, some good ear specialist should be consulted at once, 
and with equal promptness the advice and guidance should be 
sought of some teacher of the deaf trained in the speech methods. 
The physician may be able to restore normal hearing or, if not, 
then the teacher will enable the parents to render the special 
assistance that the child needs in order not to fall behind in learn- 
ing to speak and to understand. 

Educational Treatment. — The space available in this volume 
will not permit the inclusion of detailed directions for the edu- 
cational treatment of little deaf children, but the author of this 
contribution has provided this information in his little book 
entitled " What the Mother of a Deaf Child Ought to Know." 
We can only briefly indicate here the lines along which the edu- 
cational treatment of deaf children of the four classes must run 
if the closest possible approximation to the normal is to be at- 
tained. 

Home Care. — Parents, and the daily associates of children of 
the first group, those with hearing slightly impaired after speech 
has been acquired, can do all that is necessary for them. Con- 
stant and unremitting care should be taken to speak distinctly 
to these children, and there should be great insistence upon care- 
ful speech on their part. It will help greatly if the child is 
trained always to look at the lips of the person who is speaking, 



612 APPENDIX 

and if those speaking to the child will form the habit of watch- 
ing the child's eyes, and only speaking when his eyes are directed 
toward them. Also to stand, or sit, in such a way that the light 
will come from behind the child and fall upon the face of the 
speaker. The child should be taught to read early, and each 
day should be made to read aloud in the most painstaking way, 
and should be taken into the lap and be read to in such a tone 
of voice as will carry every sound distinctly to its ears. He 
should also be talked to while held in the lap as often as possible 
each day. 

The ordinary talk that is addressed to little children about 
the pussy, the chickens, the dog, his brothers and sisters, father, 
mother, and playfellows, his toys and his occupations, should be 
the subject of these lap talks. Great care should be taken to 
use good, straight, connected English, not the foolish "baby 
talk " which is so unfortunately common when speaking to 
children. 

When the child begins to go to school it would be well to 
arrange with some teacher to give him a little special attention 
in order to be sure that he does not miss some things which 
other pupils hear. 

The Second Group. — The second group, those whose hearing 
has been entirely destroyed or very seriously impaired after 
speech has been acquired, presents a more difficult problem. 
The first element in success is a prompt beginning of special in- 
struction immediately upon the occurrence of the deafness. If 
the matter is intelligently handled, the change in method of 
understanding speech from hearing to seeing can be made with 
comparative ease, and without much loss of ground education- 
ally. Unless, however, prompt and intelligent measures are 
taken, there will be a sudden and complete cutting off of spoken 
communication with the unfortunate child who has become 
deaf. Furthermore, a rapid deterioration in speech will follow 
the loss of hearing unless unremitting and expert attention be 
given to the preservation of correct enunciation. The rapidity 
and degree of this impairment of speech will depend upon the 
age at which deafness occurs. The younger the child the more 
quickly and completely will speech be lost. This misfortune is 
preventable if the case is properly handled. If the child has 
learned to read before deafness occurred, some time each day 



A MEDICAL SYMPOSIUM 613 

should be devoted to having him read aloud, paying the strict- 
est attention to the clear and perfect articulation of every sound 
in each word. Great care should be taken to keep the child 
talking as much as possible all day long, as the tendency is to 
stop talking when the hearing is lost. Careless and imperfect 
speech should not be accepted, but distinct and careful enuncia- 
tion should be insisted upon from the very start. It is almost 
essential that the aid of some one experienced in teaching speech 
to the deaf should be secured. 

Lip-Reading. — Lip-reading, that is, the understanding of 
speech by watching the face of the speaker, is usually hard at 
first, and all who come in contact with the deaf child should 
show the greatest patience and gentleness, and repeat as often 
as is necessary, in order that he may not get the idea that peo- 
ple do not like to talk with him, and so cause him to stop trying 
to understand. The future happiness and success of the child 
depends so much upon the treatment that he receives by those 
about him during the first year after deafness comes that too 
much stress cannot be laid upon these points. 

The Third Group. — Those whose hearing has been slightly im- 
paired from birth or early infancy require still a different sort of 
attention. In these cases the greatest possible use of the hearing 
thai remains, and the avoidance of imperfect articulation are the 
two things to be aimed at. An impairment of hearing so slight 
as in the case of an adult would not greatly matter, is a very 
serious thing in the case of a little child, because it prevents the 
unconscious acquisition of natural speech, and results in the 
child's speaking and understanding imperfectly unless very 
special care is exerted. From the moment that the slightest 
impairment of hearing is noticed all those who have to do with 
the child should take the greatest care to always speak clearly 
to him in a tone loud enough to be distinctly heard. 

The habit should also be formed by those in charge of the 
child of watching his eyes and speaking to him usually when 
his gaze is on the face of the speaker. If this is done for a few 
months the child will form the habit of watching the lips of 
those addressing him, and will gradually acquire a considerable 
ability to read the lips and so supplement with his eyes his im- 
perfect ears. 

He should be frequently held in the lap and talked to close 



614 APPENDIX 

to his ear, and when he is old enough to appreciate simple little 
stories he should be read to while sitting on the knees of the 
reader, whose lips should be near enough to his ear, and whose 
voice should be so pitched as to make certain that every sound 
reaches the child. 

Great care should also be taken that he does not form wrong 
habits of articulation. His speech should be watched carefully 
and every effort made to teach him to make the sounds correctly. 
He should not be allowed to form the habit of substituting Is 
and ds for ks and gs, or of dropping off the final letters and sylla- 
bles of words. In short, much more painstaking care should 
be given to his speech than is required by children whose hear- 
ing is acute. 

The Fourth Group. — Those totally deaf, or with hearing very 
seriously impaired, from birth or early infancy, include the most 
difficult cases resulting from deafness. Without the greatest 
care and the most intelligent treatment these children will be- 
come typical deaf-mutes. Being totally deaf, or very hard of 
hearing before any speech has been acquired in the natural way, 
they will never learn to speak, or to understand the speech of 
others, without the most expert instruction continued over a 
period of eight or ten years, and under conditions that surround 
them with an atmosphere of spoken communication. If, during 
the educational period, between birth and 16 years of age, 
these children are permitted to develop, or are taught, any silent 
method of communication by means of finger --spelling or the sign- 
language, they will never attain to the maximum ability to speak 
and to understand speech, of which each individual is capable. 

Even when a child is totally, congenitally deaf, if he is other- 
wise normal, he can be given as much education as he would 
have received had his hearing been perfect, and he can be taught 
some useful occupation by which he can be self-supporting. 

It is not necessary to employ either finger-spelling or the sign- 
language in giving him this instruction. Unfortunately, in some 
schools in the United States the speech environment required 
for the best results in speech-teaching does not exist at present, 
though it does exist in many other schools. Conditions are 
gradually improving, however, and in the course of time all 
schools will at least have a department in which there exists a 
speech atmosphere — that is, in which all persons having to do 



A MEDICAL SYMPOSIUM 615 

with the pupils will use only the spoken form of communication 
with them. 

Occupations for the Deaf. — It would be hard to name any 
human activity in which some totally deaf person is not en- 
gaged, but those spheres of usefulness most open to them are 
agriculture and the manual trades and arts. 

Surround the Deaf with Normal Conditions. — The variations 
from the normal of education and attitude toward life found in 
the deaf are, to a very considerable degree, due to the treatment 
which it has been customary to accord them. It is possible for 
the deaf to approximate much more closely to the normal when 
they are surrounded by more normal conditions between the 
ages of s and 16. If, instead of herding them by hundreds in 
great buildings under a single roof, and using finger-spelling and 
the sign-language in their education, they could be housed on 
the cottage plan in their schools, or be provided with properly 
organized day schools in their own towns, as is done in many 
instances, and were taught exclusively by the speech method in 
a speech environment, the unfortunate tendency of deafness to 
segregate its victims and exclude them from the ordinary inter- 
course of life would be tremendously reduced. 

From the moment deafness is discovered the treatment of a 
deaf child should not differ in kind from that of the hearing child, 
though it should differ in degree. Much more attention must be 
paid to certain things and just as much attention to all other 
things. A vastly greater amount of thought and effort must be 
given to the child's speech and understanding of language when 
he is deaf, and just as much attention must be paid to his educa- 
tion and character-building. 

Methods of Teaching.— It must at once be understood that 
those things which we ordinarily learn through our ears must 
be taught him through his eyes. Unfortunately, the eyes, un- 
like the ears, must be consciously focussed upon the source from 
which the impression comes, and that means that attention 
through the eyes must be secured and developed. Without this 
focussed attention the deaf child gets no impressions that have 
a bearing upon language. Therefore, from the very beginning, 
those associated with the deaf child should acquire the habit 
of watching the direction of his gaze, and of considering the light 
that falls upon the point they wish him to observe. So far as is 



616 APPENDIX 

possible the source of light should always be behind the child, 
as it is difficult to get accurate visual impressions when looking 
toward a bright light. Good light conditions should be care- 
fully maintained and the sight of the child safeguarded at all 
times. The child, also, should, from the first, be trained to 
direct his gaze to the faces of those addressing him. The earlier 
this habit of watching the lips of those speaking to him can be 
developed the more rapid and satisfactory will be his progress 
in understanding spoken language. The greatest difficulty in 
learning lip-reading for a child is to get as many opportunities 
of seeing language spoken when the thought that is being expressed 
is in his mind as the hearing child has of hearing spoken language 
at the moment when the situation makes its meaning clear. It 
is surprising how well the eye can interpret speech without the 
help of the ear, and if the deaf child could have as much practice 
in seeing speech under the same favorable conditions that the 
hearing child hears it, he would learn to understand when spoken 
to almost as well as if he heard instead of saw the speech. Even 
then, however, he would be greatly handicapped by his inability 
to catch anything that was said when his eyes did not happen 
to be fixed on the speaker, and would require much more atten- 
tion than a hearing child of the same mentality in order to give 
him the same amount of information and mental development. 
Unless very exceptional attention has been given a congeni- 
tally deaf child, he is at 4 years of age behind the hearing 
child of 2 so far as mental development and understanding 
of language is concerned. He has, however, a maturity of mind 
and of body not possessed by the child of 2, and if properly 
and efficiently taught can gradually overtake his hearing brother, 
until at 18 they are approximately equal from an educational 
standpoint. This result can only be attained when he has been 
given the most intelligent and unremitting attention both at 
home and in school. If the specific suggestions contained in the 
little handbook, " What the Mother of a Deaf Child Ought to 
Know," have been faithfully followed in the home up to 4K or 
5 years of age, and the child is then placed in a good oral school 
where a speech-environment is maintained, and is there given 
expert instruction in speech and efficient teaching along the 
ordinary educational lines, by the time he is 18 he will be 
able to do about all that he would have been capable of, 



A MEDICAL SYMPOSIUM 617 

with his individual mental equipment, if he had possessed un- 
impaired hearing. To attain such a result under such a severe 
handicap is a triumph of skill, patience, and devotion, as well as 
of efficient organization, that forms one of the laurels of our 
civilization. 

Deaf Children with Defective Mentality. — Up to this point I 
have been discussing the deaf child who has at least ordinary- 
intelligence. Fortunately by far the greater number of deaf 
children are of average mentality, and if it were not for their 
deafness would require no different treatment from that pro- 
vided for the perfectly normal child. 

There are, however, deaf children of defective mentality just 
as there are such hearing children, and just as these mentally 
defective hearing children should be segregated from mentally 
normal children, and should be given special care and instruc- 
tion, so should the mentally defective deaf be carefully segre- 
gated from the mentally average deaf, and given a special form 
of treatment. This statement would seem axiomatic; yet, 
strangely enough, this segregation is rarely provided for the 
deaf. A great injustice, both to the mentally defective child 
and the mentally normal child, is inflicted by placing the men- 
tally defective deaf in the same schools as the mentally normal 
deaf. I cannot protest too strongly against this procedure. It 
is a disgrace to the intelligence of those responsible for the fact, 
and the sooner that this is understood the better it will be for 
all concerned. The regularly organized schools for deaf chil- 
dren are no more the proper place for a feeble-minded deaf child 
than the regularly organized public schools for the hearing are 
the proper place for a feeble-minded hearing child. The public 
are too prone to think that the regular schools for the deaf are 
not only the places to put the feeble-minded deaf, but even 
those abnormal or subnormal children who fail to acquire speech 
for some other reason than deafness. For many years the 
public schools for the deaf were in all States under the Depart- 
ment of Charities instead of the Board of Education. This has 
already been altered in many States, thus removing an unjust 
stigma from the deaf as a class whose education is no more a 
charity than that of any other children. 



618 APPENDIX 

XII. THE BLIND CHILD 1 

By Doctor F. Park Lewis, Buffalo, N. Y. 

Fundamental Needs. — In the training of the blind child, 
three things must be emphasized: 

i. The necessity of recognizing the fact that the child is 
blind or has defective sight, at the earliest age possible. 

2. The manner in which the brain is developed through the 
training of the remaining special senses in the absence of sight. 

3. The existence of that unusual condition, more highly de- 
veloped in the blind than those who see, and what is some- 
times termed the sixth sense, touch at distance, but which consists 
in the recognition of the nearness of any material body having 
a sufficiently large surface area by the perception of its approach 
through some other than that of conscious sight, hearing, or 
personal contact. 

Early Recognition. — If there is reason to suspect that the 
sight is imperfect it is of great importance that the existence of 
marked refractive errors be discovered as soon as possible. In a 
very large number of markedly hypermetropic eyes, or far- 
sighted eyes, or those in which the two eyes are focally different, 
and more especially when one eye converges and there is a per- 
manent squint, the brain area corresponding to the sight centre 
of the inturned eye ceases to function, and, following the law of 
nature, those functions which are not used cease to have the 
power of use. There has developed, therefore, an amblyopia, 
or dull sight, which, if uncorrected, becomes permanent, and a 
semiblindness of the inturned eye, lasting through life, is the 
consequence. 

If, on the other hand, the proper refractive correction is 
made early enough, and the neurons, or nerve-endings in the 
brain corresponding to the sight centres, are made to function, 
the sight may be permanently preserved. 

It is a matter of first importance that in cases of squint the 
child be sent to an oculist as soon as the defect is discovered. 
I have, myself, used with great satisfaction strong correcting 
glasses upon a baby as young as five and one-half months old. 

1 This contribution is a compilation from several of Doctor Lewis's papers, 
made with the author's special authorization. 



A MEDICAL SYMPOSIUM 619 

Sometimes the presence of congenital myopia, or near sight, in 
very high degree gives the child a vague blind look which may 
lead to a mistaken diagnosis of idiocy. 

I have seen such an instance in the case of a 5-year-old 
child whose eyes were myopic to the extent of ten diopters. 
To such a child all objects beyond five or six inches would have 
the appearance of being shrouded in mist, and the educative 
value of the visual pictures that are constantly being presented 
to the seeing child was thereby lost to him. The correction of 
the refraction gave the child such a degree of improved mental 
control as would hardly be thought possible. 

As all young babies roll their eyes aimlessly during the first 
weeks of life it is difficult to determine, from observation merely, 
the absence of sight. This difficulty is increased if, as more 
commonly happens, blindness is not complete, but objects are 
imperfectly seen. If, however, the pupils are widely dilated 
and unresponsive to light; if the eyes continue to move aim- 
lessly from side to side without attempt to fix them on any 
object; and more particularly when nystagmus, or spasmodic 
twitching of the eyeballs is present, associated with an unwill- 
ingness or an inability on the part of the child to follow a light 
with his eyes when it is moved before him, there would be strong 
presumptive evidence after the sixth month that the vision was 
so imperfect as to warrant an ophthalmoscopic examination by 
a capable oculist by which a conclusion can be reached with 
much greater certainty. 

Early Impressions. — However rapid may be the development 
of the child after he has reached school age, the period of great- 
est plasticity and quickest responsiveness is during the months 
of babyhood and the early years immediately following, and it 
is through the sense of sight that impressions, carried to the 
cortex, or surface of the brain, exercise the most profound influ- 
ence upon the brain development. With the visual images every 
other sense impression is correlated. The object which the 
child sees, in order that he may realize its position in space, 
must be verified by the sense of touch. All of those sensory 
nuclei, therefore, which have been energized by the touch of 
the fingers, if the object is held in the hand, of the feet as they 
touch the floor, of the arms and limbs as they move through 
the air — every one of these millions of neurons is brought into 



620 APPENDIX 

direct relationship with the corresponding number of other 
neurons in the sight centre, so that every motion is sending a 
flood of nervous energy surging through the brain of the child. 
In that way he becomes conscious of his position in space, and he 
develops what is known as the stereognostic sense — or the con- 
sciousness of solid objects. 

Cut off as the blind child is from the primary energizing in- 
fluence of the visual impressions, he is intellectually hampered 
and limited unless every possible supplemental effort is employed 
to replace, as far as may be, the advantages which, in comparison 
with the seeing child, he is obliged to sacrifice. 

The blind baby, not seeing the objects around him, is not, as 
is the seeing child, unconsciously or persistently being educated 
as to their form, their size, their importance, their meaning, in 
a word: their value. He lives in the dark, and every motion or 
every step which he attempts to make is an experiment and an 
adventure. The next step may precipitate him he knows not 
where. It may be from the top of a stairway. He can have 
no means of knowing. He is living in a world separate and dis- 
tinct from that of his seeing associates. This fact should be 
early recognized and constantly borne in mind. The blind 
baby must be talked to more than the child who sees. He must 
be allowed, carefully, to touch the objects about him, in order 
that in that way he may learn what he can about them. He 
must not be startled by being touched suddenly and without 
warning. He must not be allowed to be frightened by taking a 
misstep. A nervous impression of that kind may leave its 
results for months, if not for years, upon that sensitive organism. 
When he is old enough to creep he should be allowed the freedom 
of a room from which all objects against which he might hurt 
himself have been removed. The floor should be of one level 
so that there may be no pitfalls for him. He must be allowed 
all manner of harmless things to handle, and he must always be 
spoken to when one comes near him that he may not be startled. 
Large motor and sensory areas may be trained by allowing him 
to feel, to touch, and to handle things varying in degrees of 
hardness, and smoothness, and of different shapes and forms. 
He will in that way be getting such approximate impressions as 
he can, limited as those are compared to the possibilities of the 
seeing child. 



A MEDICAL SYMPOSIUM 621 

At a very early age, too, auditory areas may be actuated by 
singing simple melodies to the child, not in a vague and mean- 
ingless way, but carefully and in tune where it is possible for 
the mother to do so. The attention in that way can be directed 
and a recognition of different tones will begin at a much earlier 
age than is ordinarily supposed. Let it constantly be remem- 
bered that all of the moving pictures that pass before our eyes 
are blotted out for the blind baby. There is nothing but dark- 
ness before his unseeing eyes, and this monotony must be varied 
by greater attention to details that will interest him than 
would be necessary with a seeing child. 

At a very early age any other existing corrigible physical 
defects should, if possible, be removed. It is bad enough for 
the child to be blind. He should not be still further handi- 
capped by the presence of large tonsils, by adenoids, and the 
consequent otitis and deafness, or any other defects of the body. 

The training of the voice to make it as musical and sympa- 
thetic as possible will be a great advantage to the child, and a 
quiet, self-possessed manner instead of a nervous and jerky one 
will not only make him more agreeable, but will give him bal- 
ance of mind as he has poise of manner. 

In a word, before the child can be placed under the systematic 
and special training provided for the sightless, much can be 
done by the intelligent mother, under the advice of the physi- 
cian, to so aid the child's development as to make life easier 
and simpler when the systematic training of the school com- 
mences. 

School Training. — The time in which the blind child should 
be placed under the instruction of those specially qualified to 
train him in a school for the blind is the earliest period at which 
children are admitted, and that is the kindergarten age. Very 
often mothers do great injustice to their children by failing to 
realize this important fact. The mistake is often made in keep- 
ing him at home through mistaken sympathy, when he should 
be under definite and systematic training. It is not at all un- 
usual to find that blind children are denied the privileges of 
training until they are 13 or 14 years old, and are then 
reluctantly sent to the special schools and find themselves 
utterly handicapped by their inability to do the simple things 
that other blind children easily do, because of the mistaken 



622 APPENDIX 

kindness of parents and friends. They are unable to put on 
their own clothes, to button their shoes, or to use their hands 
and fingers in the simplest mechanical effort. The handicap 
which they suffer is so great that it can never be completely 
overcome. 

If the blind receive suitable training at a sufficiently early 
age to develop in them that strength of body, of intellect, and of 
character that is the prerequisite of any successful life, their 
possibilities, strange as it may seem, are not greatly lessened by 
their loss of sight. This has been demonstrated in the lives of 
a multitude of successful blind men and women. England's 
ablest postmaster-general, Mr. Faucett, was blind. He rode 
horseback, skated, and did many things that are supposed to 
require eyesight. The most wonderful and exact observations 
on the life history of the bee were made by a blind man, who 
directed the eyes of his servant. Blind musicians have written 
and played, and Mount Blanc has been scaled by blind men. 
It is the mind and the spirit which control, and when these 
are great they dominate and rise superior to mere physical 
deficiencies. The inspiration of great ideals must be held 
out to the blind, even more than to the seeing from the 
beginning. 

Need of Normal Companionship. — At as early a period as 
possible in the child's life, he should be given an opportunity 
to play with other children of his own age. With a little 
supervision, he can be taught to enter into all of their games, 
and to do a great many things that are done by seeing chil- 
dren. It is as true of the blind as it is of those who see that 
the most important elements in their education come not 
from teachers but from their associates. The effect of hav- 
ing a blind child among a group of seeing children is mutually 
helpful. If the children are properly taught, they will soon 
learn to supplement the lack of sight in their companion by giv- 
ing him a little help when necessary. They will learn to tell 
him of things that are about him and describe the things as they 
see them, and in consequence they will learn how to observe 
and express their thoughts, while he will quickly begin to form 
mental images, as far as he can form them, from his surroundings. 

Special teachers for blind children are exceedingly difficult to 
obtain, and they are rarely necessary. It is not usually desir- 



A MEDICAL SYMPOSIUM 623 

able that the child should be placed under the care of a gov- 
erness or tutor, so essential to the development of the child is 
the contact with other children. In some of the larger cities, 
such as Chicago and New York, provision is made in the pub- 
lic schools for blind children, and those having such defective 
sight that they are unable to follow the usual school curricu- 
lum. In almost every State there is now a school for the 
blind, and where special provision is not made in the public 
schools, or even sometimes when there are special classes, the 
child should be sent to a school for the blind at the kinder- 
garten age. 

It is the general opinion of those teaching the blind that the 
more nearly they can be trained as seeing children are, and the 
fewer distinctive methods are employed, the easier will it be 
for them to adjust themselves later in life to conditions that 
obtain among the seeing. 

It has seemed necessary up to the present time that special 
schools should be provided for the blind, but thoughtful students 
of pedagogy are beginning to believe that to have the blind in 
classes of seeing children is not infrequently of mutual advan- 
tage. During a period in which a school for the blind was un- 
dergoing repairs, a bright and ambitious pupil was taken tem- 
porarily into a class of a high school in a near-by city. When, 
after some months, he returned to his own school, the superin- 
tendent, in speaking of this boy's work, said that his presence 
in the school had been of greatest help to the other lads with 
whom he had worked in class. His success in overcoming diffi- 
culties was a stimulus to their pride, and an incentive to their 
ambition. His presence in class was a constant reminder to 
them of their superior physical advantages, and they were 
ashamed to have him outstrip them as he did in their intellectual 
work. The lad was of a gentle, kindly disposition, and his fellow- 
students emulated each other in showing little kindnesses to 
him, and he introduced thereby into the atmosphere of the school 
a quality of self-sacrifice, of courtesy, and of chivalry, the effect 
of which was long continued. 

The added importance of having blind children educated in 
connection with those who' see is that they may realize more 
keenly the real difficulties of life which are to be met and which 
have to be overcome. They will not always find kindness and 



624 APPENDIX 

courtesy, and they must be prepared to adjust themselves to 
the harder conditions when they arise. 

Some Remarks on Method. — Even for the younger children, 
special appliances for the ordinary conveniences of life are 
rarely necessary. They must eat at the common table, they 
must use the knives, forks, spoons and plates that other people 
use, and in the way that other people use them. 

One of the most important elements in the instruction of the 
blind is that they should be trained early to distinguish coins 
from the sense of touch. This is not difficult but it requires a 
little special application. The size of a penny, a dime, and a 
quarter are sufficiently unlike to make it possible for blind per- 
sons of keen intelligence to immediately distinguish them. 
When the sense of touch is sufficiently trained it is possible to 
differentiate between American and Canadian coins, even when 
of the same denomination. A blind lad in one of the State 
schools has his ear so acutely trained that when coins are jingled 
together in the pocket he is able to tell with almost absolute 
accuracy the number of coins and their value, and whether they 
are silver, copper, or nickel. As each has a tone peculiarly its 
own, it is only necessary that the ear should be keen and that 
close attention be given in order that this may be done. 

In the training of the special senses other than that of vision, 
the absence of sight, so far from being a disadvantage, is a posi- 
tive help. While it is now generally recognized that no one 
sense is made more acute by the absence of others, the oppor- 
tunities for special training are greater, and the probabilities 
are that the blind child will have keener hearing, if no organic 
defect is present, than the child who sees. 1 

Varieties of Work. — In the education of the blind child of 
course it must be early determined, as with those who see, what 
in general are the broad lines of limitation. There are those 
who are mentally sluggish who may be made more active, and 
there are those who from congenital deficiencies must always 
remain upon the border-line of intelligence, or among the vast 

1 It cannot be the purpose of this book to enter into the details of the teach- 
ing of the blind. The author therefore omits references to methods of teaching 
reading and writing (the "American Braille" or point print; the Moon alphabet), 
the use of the typewriter for the blind, etc. All this is special work which can 
be studied by those interested in the literature of the subject. — M. P. E. G. 



A MEDICAL SYMPOSIUM 625 

number of those in whom the loss of sight is the only incorrigible 
defect. The possibilities of mental development are quite as 
great as among those who see. 

The possibilities of the blind and the varieties of work which 
they can do are much wider than ordinarily realized. There are 
blind persons who are successful in business, in the law, in medi- 
cine; they have become successful teachers, musicians, and 
writers. Many simple mechanical lines of work are satisfac- 
torily taken up without the aid of sight. It is readily evident, 
however, that those occupations which are mental rather than 
physical are those in which they succeed in the highest degree, 
and when it is possible these should be the lines chosen for those 
who must make their way in the world without sight. 

Amusements and Special Inventions for the Blind. — The 
amusements of the blind must not be neglected. It is depress- 
ing to live in a night that has no morning. It is frequently easy 
for friends to bring much cheer into such lives with little effort. 
The New York Association for the Blind had as its initiative the 
establishment of a ticket bureau to which those having tickets 
for concerts and lectures which they were unable to attend were 
asked to send them for distribution to the poor blind, to whom 
such opportunities were rare. Such bureaus are easily conducted 
and give much pleasure at little cost. Playing-cards are made 
for the use of the blind, having on one corner raised marks in- 
dicating their value. They also have special forms of games, 
such as chess, dice, dominoes, mechanical puzzles, and other 
objects of interest and instruction. 

The most convenient method of correspondence for the blind 
is by all means the typewriter. Its use is easily acquired, and 
no special appliances are necessary. It can be used by means 
of the touch system without the necessity of sight. Many 
blind typists are as expert and as accurate as those who see. A 
system of stenography has also been devised for the blind in 
which raised notes can rapidly be taken, and these are rapidly 
transcribed by the typist. 

A watch has been invented for the blind or those who wish 
to tell time in the dark. The hours are represented by twelve 
movable metal dots. Each dot disappears as its hour is reached. 
This necessitates only the use of a minute hand. The four pegs 
placed at the quarters enable a quicker reading of the time. 



626 APPENDIX 

For the intelligent blind man, however, no such device is usually 
necessary. He uses the ordinary watch from which the crystal 
has been removed, and from his knowledge of the location of 
the hours he is usually able by touching the minute hand with 
the finger, to determine the time with great accuracy. 



XIII. HEREDITARY WEAKNESS, PREDISPOSING 

TO TUBERCULAR DISEASES, AND ITS 

PREVENTION 

By Doctor Theodore Toepel, Atlanta, Ga. 

Predisposition vs. Heredity. — It is a well-known fact which 
is supported by scientific findings that tubercular conditions 
are not inherited, but that the predisposition, such as bodily 
weakness, is transmitted from the parents to the children. 

It therefore becomes the duty of the parents to live a hygienic 
life under the most favorable sanitary conditions in order to 
have their children endowed with the most essential requisite 
of life, namely health. 

Systematic Habits of Living. — The parents must adopt sys- 
tematic habits of living; to do the right thing over and over 
again relieves the brain of unnecessary thinking about what 
must be done. 

It is well to start the day on schedule time without losing a 
minute; this necessarily requires regular habits of retiring in 
order to give the body rest in the form of sleep. 

In my opinion and experience I have found the sleeping-porch, 
open on two sides, to be the best place to get a good night's rest; 
where this is not possible one should sleep with all windows 
open, invigorating the body with fresh air for the next day. 

The length of time necessary to rest the body depends alto- 
gether upon the individual, his nervous system, muscles, organs, 
temperament, and his daily pursuits in life. Our great Edison 
claims that four hours is sufficient for any one, and sleeping more 
tha/i that is stealing from productive power; while the famous 
Gladstone found eight hours necessary to keep his body re- 
freshed for daily work But to-day most hygienists agree that 
the average body requires eight hours of sleep. 



A MEDICAL SYMPOSIUM 627 

Exercise. — Exercise being as necessary as sleep and food, it 
is advisable on arising to go through a set of exercises which 
involve the large muscles of the body, in a room where the tem- 
perature is comfortable so that the body is in a glow before the 
bath. These morning exercises start every organ in your body 
in the right direction, especially the circulation, and you are 
ready for the bath. 

Stimulants. — Some people require their morning toddy as a 
stimulant to start the day, others must have a cup of strong 
coffee or coca cola. But I agree with Benjamin Franklin, whose 
rules of life were: " Tolerate no uncleanliness in body, clothes, or 
habitation." The best morning tonic after the exercise is to 
get into a tub of cool water, giving the body a good rubbing 
with a coarse towel before putting on clean clothes. At least 
twice a week, just before retiring, every one should take a 
warm bath, using plenty of soap. 

Mouth Hygiene. — More and more does the medical profes- 
sion realize the importance of proper mouth hygiene. In co- 
operation with the dentists, much has been accomplished in 
reducing the spread of diseases, especially that of tuberculosis, 
by keeping the mouth clean. Brush the teeth every morning 
with warm salt water, then drink a glass of cool water. 

Dress quickly and carefully without rushing, being sure that 
the underclothing is clean, and that the top clothing is brushed 
and neat-looking. 

Breakfast. — The breakfast should consist of simple, plain 
food, such as fruit, cereal, and milk with bread and butter rather 
than steak, fried potatoes, hot biscuits, and muddy coffee. Take 
your time and eat slowly; you will get more benefit from it. 
It is not how much you eat, but how well you assimilate that 
makes it nourishing. 

When all the processes of digestion work together properly, 
there should be a perfectly natural and regular evacuation of 
the bowels. The frequency of such evacuations varies somewhat, 
and is largely a matter of habit. With some people it is twice 
a day, with others once every other day. But with the vast 
majority it is normally once a day, and about the same time, 
shortly after breakfast. 

Professional Precautions. — To enumerate all the many pre- 
cautions that the different occupations and professions require 



628 APPENDIX 

would make this contribution too lengthy. Suffice it to say 
that a number of States are now protecting the employees of 
dangerous occupations by requiring safety appliances on ma- 
chines, and guards to prevent the inhaling of dust or poisonous 
fumes. 

Other Matters of Daily Routine. — Go to your place of busi- 
ness leisurely, avoid rushing so as not to disturb the diges- 
tion, if possible walk — walk with your head high and your 
chest up. 

With all these good habits formed you will begin your work 
cheerfully, you will choose friends who are cheerful and amiable, 
and your daily life will be one of joy. 

If possible, take a rest at noon, go home and eat a meal in 
company with your loved ones. Again, as for breakfast, eat 
simple food, such as soup, vegetables, one meat and a glass of 
water; rest fifteen minutes after the meal, then return leisurely 
to your place of business. 

Some time during the hours after noon, a person should find 
time to do some recreative work, i. e., work different from the 
daily routine in the office, shop, or home; an [hour spent in 
the garden, or on the golf-links, or tennis-court, will tone up 
the whole organism, and will help to remove the accumulated 
poisons collected during the hours of routine labor. 

When you sit down to your evening meal, remember only the 
pleasant and humorous things of the day which you can relate. 
It is very necessary that the food shall be light, wholesome, and 
easily digestible. After supper, in company with the family, 
every one should partake of some interesting recreation which 
will act as a safety-valve or outlet for superfluous energy, as 
well as rest and change from the regular work. 

Special Precautions. — Besides these general rules of hygiene 
it is well, if one of the parents has contracted the tubercular 
bacilli — which fact has to be ascertained by a competent physi- 
cian — that special precautions be taken so as to prevent the 
spread of bacilli to some other members of the family. 

The wisest plan is to isolate the infected member either by 
sending him to one of the many institutions where he receives 
special care and where the disease is arrested; or by having him 
sleep and live in the open air at home, practising the necessary 
precautions. If the patient has fever, absolute rest is essential; 



A MEDICAL SYMPOSIUM 629 

where no fever is present, moderate exercises may be taken with 
care. 

He should have an abundance of nourishing food, especially 
of fatty food, meat, eggs, and milk. Any other foods that he 
likes to eat and can digest should be taken. Lunches should 
be eaten between meals and on retiring. A skilled physician 
should watch and guide him in the treatment and should institute 
such regulations in the household which protect the other mem- 
bers of the family against any possibility of contracting the tu- 
bercular disease. 

The patient should always think of the safety of others, and 
should take care not to endanger those about him. 

Conclusion. — I wish to reiterate that, although it is a fact 
that some families are more affected by tuberculosis than other 
families, it is not true that children in these families are born 
with the tubercular bacilli in their bodies. But it means that 
they have less power to kill these bacilli. Every person has the 
opportunity of increasing his power of resistance by adopting a 
hygienic life such as is laid down in this simple outline. 

XIV. OUTDOOR SCHOOLS AND MEDICAL TREAT- 
MENT FOR EXCEPTIONAL CHILDREN 

By Doctor Edward S. Krans, Plainfield, N. J. 

The writer's experience has been limited to the groups of 
pseudoatypical children and atypical children proper. The 
former, as a rule, respond quickly to fresh air, food, and the cor- 
rection of minor bodily ills; while the latter require more time, 
more pedagogic manipulation, more care in adapting the daily 
regime. 

Routine of Medical Treatment. — In undertaking the medical 
treatment of such cases the following routine is observed as far 
as possible: 

(i) Provision is made for suitable diet, bathing, outdoor air, 
exercise, and abundance of sleep. 

(2) Investigation of conditions at home and in school to in- 
sure proper mental and moral training, congenial pursuits, and 
giving parents and teachers explicit advice. 

(3) The correction of physical abnormalities, especially as 



630 APPENDIX 

regards the teeth, eyes, nose and throat, genitalia, digestive 
tract, blood, and spine. 

Pedagogical Co-operation. — In regard to the ethical and intel- 
lectual phases of the problem, the physician needs the aid of a 
good pedagogue, and for difficult cases, one specially trained in 
the psychology of childhood and adolescence. 

Outdoor Provisions. — The writer believes that the proper 
environment for exceptional children is nearly always found 
outdoors. The open-air school, the open-window or cloth-window 
classes, are simple adjuncts to public or private schools, and may 
easily be applied in principle to one or more pupils under tutor 
or governess. The open-window and cloth-window classes are 
the ideal for all classes, and are inexpensive, involving no altera- 
tion in buildings. The open-air school is an ungraded class 
with not more than twenty members, to whom are administered 
carefully adjusted doses of fresh air, good food, mental and 
manual work, play, rest, and exercise. 

School Routine. — Experience has evolved certain essentials 
in regard to the school routine and to the structure in which the 
school is located. So far as the day's programme is concerned, 
it is the ideal programme for the exceptional child indoors or 
outdoors, and subject to necessary variation it should be about 
as follows: 

In the morning, on arrival, the children have pulse, tempera- 
ture and respiration recorded; the hungry ones receive milk and 
bread, after which, as after all meals, they brush their teeth. 
After a cold shower-bath,' an hour and a half is devoted to study; 
then comes a twenty minutes' recess of active play, followed by 
a half-hour of rest with music or out-loud reading. Then study 
is resumed for an hour until dinner-time. After dinner the 
children have a period of actual sleep, from which they are 
called to their classes for one or two hours. Before leaving in 
the afternoon, temperature, pulse, and respiration are once more 
recorded, and those desiring it may have bread and milk. In 
the case of poor children the school or district nurse should visit 
the homes to look over conditions, make suggestions, and take 
cases to hospitals or dispensaries; while among those in better 
circumstances the task falls to, and is usually neglected by, the 
family physician. Examinations of the children, stripped to 
the skin, should be thoroughly made at regular intervals, with 



A MEDICAL SYMPOSIUM 631 

at least one examination of blood and urine, and such other 
laboratory work as seems necessary in each case. 

Practical Conditions. — The success of an outdoor school de- 
pends in a large measure upon a few practical conditions. For 
example: It should be possible to enclose the school on three 
sides that are removable, or that contain windows. There 
should be a rain-proof roof and a dry floor. The open side must 
face the south, and along it is a broad windbreak, as high as the 
children's waists when seated, to keep off the cold winds from 
feet and legs; for it is impossible to keep the children warm if 
the feet are cold. Very heavy woollen suits with hoods, and felt 
lumberman's boots are worn in winter, and on the cots ready for 
the rest hour are several large army blankets, one beneath and 
two or more on top of each child. Close at hand there should 
be a warmed room for changing clothes, warming up the chilled, 
as a refuge from storm, and with a bathroom and toilet adjacent 
to it. 

Results from Outdoor School Life. — The results from outdoor 
school life have been gratifying. This is especially true in the 
case of neglected children, the anaemic following acute illnesses, 
tonsil and adenoid cases, and children considered predisposed 
to tuberculosis. Good results have also been obtained in chorea, 
neurasthenia, hysteria, habit spasm, and uncontrolled, emotion- 
ally unstable children. 

As a rule, no effort should be made to hurry the pupils through 
a grade, but rather to secure accuracy and quickness in the 
mental processes; and the teacher's tests will, with few excep- 
tions, prove what progress of this qualitative sort can be made. 
Attendance and conduct ratings are higher than for the same 
children in the ordinary school. In addition there is a marked 
improvement in health indicated most graphically by an ascent 
in the weight curve. In a school under the writer's observation 
this gain in weight averages between seven and eight pounds 
for the nine months of the school session. 

The first open-air school in this country was started ten 
years ago, and the records of each succeeding year, and of each 
new school have emphasized the therapeutic value of the method. 
About 15 per cent of them are for the tuberculous — the remain- 
der, about 85 per cent, for children roughly classified as below 
par, as anaemic, debilitated, delicate, neurotic, backward, predis- 



632 APPENDIX 

posed to tuberculosis, and including a variety of children for the 
most part included in the pseudoatypical and atypical groups. 

Medical Treatment. — In addition to hygiene, the medicinal 
treatment must be briefly considered. Excepting the emergen- 
cies of acute illness, the use of drugs with these children is re- 
stricted to iron, arsenic, strychnine, malt, cod-liver oil, olive-oil, 
paraffin-oil, mercury, salvarsan, sometimes bromide, and not in- 
frequently some preparation of the ductless glands. Among the 
last mentioned there are great possibilities as well as disappoint- 
ments in their use in childhood; as for instance the use of thy- 
roid not only for cretins but for children showing mental and 
physical anomalies that have a cretinoid tinge. The effect of 
thyroid on calcium metabolism has led to its use in rickets, 
faulty dentition, and nutritional disorders, i. e., in conditions in 
which were formerly used thyroid-gland stimulants, such as cal- 
cium, arsenic, and iodine. Thyroid is of value in enuresis and 
eczema, provided it is used in small doses and in patients of a 
myxedematous type, while with the alert and physiologically 
active type it is useless or injurious. In enuresis, the pituitary 
may act when the thyroid preparation fails. Pituitary, and 
sometimes adrenal medication relieves the constipation that is 
so troublesome in asthenic children. Thymus gland, and occa- 
sionally and paradoxically small doses of thyroid, exert a benefi- 
cent effect in children of the hyperthyroidal type— the type that 
in extreme form in older patients presents the clinical picture of 
Basedow's disease. Another stigma, not uncommon in child- 
hood, is obesity, which, as in adults, is of two kinds: a flabby, 
sluggish hypothyroidal form that improves on thyroid extract; 
and a massive, sthenic variety that may be modified by pituitary 
administration. 

Of the sex glands, ovarian substance will stimulate menstrua- 
tion and uterine growth, while corpus luteum regulates the men- 
strual flow. In sexual infantilism, it is claimed that the use, 
singly or combined, of thyroid, thymus, pituitary, and, in the 
female, ovarian preparations, will induce normal development; 
and it is interesting, in view of the long-recognized relation be- 
tween uterus and mamma?, to note that mammary gland will 
often control the flow of blood from the uterus (not in acute 
bleeding), and that ovarian medication will assist the growth of 
the breasts. 



A MEDICAL SYMPOSIUM 633 

Suprarenal extracts are useful in asthma, and possibly whoop- 
ing-cough. 

The organs mentioned have been used for other purposes 
with varying results by different observers, and some of the state- 
ments made might properly be questioned. Many of the con- 
tradictory results of opotherapy are due to failure to recognize 
a truth that lurks behind the following theory: In administering 
one gland not only may its effects be elicited, but also those that 
follow the stimulation or depression by it of interrelated glands; 
and further, a glandular preparation may be given to replace de- 
ficient secretion, or in small amounts to act as a regulator of 
irregular functioning. An illustration of the first statement is 
the tonic effect of thyroid extract on ovarian function; and of 
the second, the astonishing result of light thyroid dosage in cer- 
tains cases with symptoms of thyroid overaction. 

Co-operation of Medical and Pedagogic Science. — Children 
with fresh tissues and sharper physiologic responses are better 
subjects than adults both for hygiene and for therapeutics. It 
is a duty, ethically and economically, to bring to the solution of 
the child problem, especially this aspect of it, every crumb of 
scientific experience. It is natural that physicians should em- 
phasize the deviations from normal physiology in these excep- 
tional children, and it is quite as natural that educators should 
lay stress on the aberrant psychology of them. But it is to be 
hoped that as mind and body travel in company in the child, 
so a representative of each may be found among those who guide 
him. 



XV. DUCTLESS GLAND IRREGULARITIES IN 

EXCEPTIONAL CHILDREN AND 

THEIR TREATMENT 

By Doctor E. Bosworth McCready, Pittsburgh, Pa. 

Importance of the Ductless Glands. — It is now generally con- 
ceded that the chain of ductless glands, comprising the pineal, 
pituitary, thyroid, thymus, and adrenals, is of the greatest im- 
portance in the development of the cerebrospinal and osseous 
systems in early life, and that impairment of function of one or 
another of these glands underlies many disorders of nutrition 



634 APPENDIX 

which inhibit proper physical and mental development. While 
our knowledge regarding the normal action of these glands is 
still somewhat hazy, yet they are found, in some manner, to 
preside over certain correlations of the body. These correla- 
tions are exceedingly variable, and this variability is most ap- 
parent when and where circumstances are abnormal. The ad- 
justing mechanisms of development are more or less reciprocal; 
thus a ductless gland not only influences development, but is 
itself influenced by changes in general development. 

Various Functions of the Glands. — There is reason to suppose 
that in the harmony produced through the concerted action of 
the ductless glands, the leading role is played by the thyroid, 
which supplies the stimulus for bodily metabolism. As a check 
upon the influence of the thyroid in infancy and childhood, the 
thymus, the general lymphatic system, and perhaps the pineal 
gland also become active. These, in addition to their inhibitory 
action, produce that delay of sexual activity which is essential to 
the proper maturation and stability of the somatic functions. 
In due time the adrenal system stimulates the sexual organs to 
action, as well as hastening the growth of the muscular and 
skeletal systems. Of great importance at this time is the action 
of the secretion from the pituitary gland, which stimulates the 
development of every organ in the body. This much may be 
postulated regarding the influence of the internal secretions upon 
somatic development. Their influence upon psychic develop- 
ment is no less important. 

Seldom, if ever, do we find a case of defective development in 
which the anomaly can be attributed exclusively to irregularity 
of action of a single gland. Even in cretinism there is some doubt 
as to whether hypothyroidism is the only factor, as this condition 
has been found accompanied by an enlarged pituitary. It may 
be stated that even in the acquired forms of ductless gland dis- 
order, such as result from infection, trauma, new growths, etc., 
in a gland previously healthy, disturbance of one of the chain 
throws others more or less out of harmony, with resulting varia- 
tion in development. 

Ductless Gland Irregularity in Exceptional Children. — The 
majority of exceptional children in whom the condition is not 
due to purely environmental influences, present evidence of duct- 
less-gland irregularity, emphasized often in one particular gland. 



A MEDICAL SYMPOSIUM 635 

The involvement may be due to causes distinctly hereditary in 
origin, to antenatal agencies affecting the child in ulero. or to a 
combination of these with exciting factors, toxic, emotional, or 
traumatic, operating postpartum. Thus conditions having a 
vitiating influence upon cell development, as tuberculosis, syph- 
ilis, cancer, alcoholism, chemical poisons, malnutrition, and 
environmental influences of various kinds occurring in the pro- 
genitors, result in imperfect growth of the development embryo. 
In the first few weeks of fetal life, when the ductless glands begin 
to appear, the cells of which they are composed also grow im- 
perfectly: and failing to secrete to the extent to which they were 
destined, further defective development ensues, and we have 
as a result a constitutional inferiority, infantilism, hypoplasia, 
degeneracy — call it what you will — in varying degree. Of these 
terms 1 prefer "hypoplasia." "Constitutional inferiority" is 
liable to confusion with Doctor Adolph Meyer's more specific 
term, " psychic constitutional inferiority," which is often used 
without the qualifying adjective. " Infantilism," especially 
when qualified as " thyroid infantilism," " pituitary infantilism," 
etc , conveys the impression of a clinical entity. " Degeneracy," 
from long misuse, carries with it a stigma of moral obliquity. 
" Hypoplasia," on the other hand, seems to be a generic term 
admitting of wide application. Hypoplasia may affect any or- 
gan or any structure, and to almost any degree. Thus hypo- 
plasia of the nervous system may give us the idiot as one extreme, 
and what is called the neurotic make-up as the other. The 
various stigmata of degeneracy are somatic manifestations of 
hypoplasia. Certain neuroses and psychoses, drug habits, al- 
coholism, etc., if not the direct result, are prone to occur in in- 
dividuals presenting symptoms of hypoplasia of the nervous 
system in greater or less degree. Chlorosis, appendicitis, tuber- 
culosis, and a host of other dyscrasias, diatheses, infections and 
morbid states are common in the hypoplastic. 

The Hypoplastic Child. — The hypoplastic exceptional child is 
distinguishable from his normally constituted fellow through 
anatomic, physiologic, and psychic characteristics, the interpre- 
tation of which will implicate the glands of internal secretion as 
a factor of etiological significance. The clinical picture most 
often observed is the undersized, undernourished child whose 
unstable nervous system is still further handicapped by the effect 



636 APPENDIX 

of disturbances arising from nasal obstruction, defective vision, 
phimosis, etc. These conditions are often erroneously consid- 
ered direct causes of mental deviation. They are, in reality, 
evidences of the evolutional hypoplasia which is the cause of the 
deviation. Other symptoms are: delayed epiphyseal union (as 
revealed by the X-ray), irregular dentition, and abnormalities 
in the growth of hair. Deficiency of the eyebrows in the outer 
third, the signe du sourcil, is considered a symptom of thyroid 
insufficiency. Enuresis is common. Frequently ptoses of the 
viscera are present, especially in the female, and postural defects 
are the rule in both sexes. Puberty may be delayed, the boy 
retaining the falsetto voice and bodily proportions of childhood, 
and the girl the " neuter " form lacking secondary sexual char- 
acteristics. There is usually a corresponding psychic insuffi- 
ciency. The high-arched palate, produced by yielding of the 
palatine bones, due to relative poverty in calcium salts, is a 
fairly constant symptom of hypoplasia, and resulting dental 
malocclusions are frequently found. 

The temperature is apt to be variable, subnormal at times 
with cold extremities, clammy skin, and chilliness, evidences of 
deficient oxidation and nutrition often due to hypothyroidism. 
Low blood-pressure, Sergent's white line, adynamia, sometimes 
with slight bronzing of the skin, and decreased resistance to in- 
fection point to underdevelopment of the adrenals. Anomalies 
of bony development hint at defective function of the thymus. 

Deformation of the Sella Turcica. — The clinical study is not 
complete without a radiograph of the region of the sella turcica, 
to determine possible deformation of the structure with resulting 
dyspituitarism. The findings must be interpreted with reference 
to symptoms of disorder of this gland as well as their relation 
to other glands of interna) secretion. A small sella turcica will 
often be found in children of retarded physical and mental de- 
velopment, exhibiting infantile characteristics approaching the 
Lorain type or the dystrophia adiposo-genitalis of Frohlich. In 
some there is an enlargement of the clinoid processes, particularly 
the posterior, practically closing the space. This finding, almost 
constant in certain forms of epilepsy, confirms Johnston's ob- 
servations. 1 I have also noticed it in children without epileptic 

1 George C. Johnston, "The Pituitary Gland in its Relation to Epilepsy," 
Surgery, Gynecology and Obstetrics, April, 1914. 



A MEDICAL SYMPOSIUM 637 

history but presenting evidence of mental instability. I am in- 
clined to believe that the deformation of the sella and of the 
clinoids is but another of the already long list of stigmata of 
degeneracy common in hypoplastic individuals, and that its 
association with epilepsy is more or less accidental, and that it 
acts as a causative factor only in so far as the resulting mal- 
functionating of the pituitary gland influences metabolism. The 
high neutral sulphur content which I have found in the urine 
of epileptic children with encroaching clinoid processes would 
tend to bear out this theory. 

Treatment. — In the last few years a fund of knowledge has 
been gradually acquired that has placed organotherapy upon a 
rational foundation and furnished concise indications for the 
administration of definite gland substances in definite diseased 
states. While in the class of cases which we are considering the 
indications are not so definite and the administration must be, 
for the present, upon more or less empirical grounds, we are far 
removed from the crude empiricism of the days of Brown- 
Sequard and his overenthusiastic followers. 

Though the most brilliant results have been gained from the 
use of thyroid gland there are many instances in which much 
benefit has apparently been derived from the use of preparations 
of other glands, and numerous such cases have been reported. 
As has been mentioned, it is seldom that we observe a case in 
which the anomaly can be attributed to irregularity of action 
of one particular gland, though there are numerous cases in 
which the symptoms involving one gland are more prominent. 
With a polyglandular condition to treat, the indication is for 
polyopotherapy. I am in the habit of administering to such 
cases small doses of pituitary, thymus, thyroid, and adrenal 
glands. For males, testicular substance is added; for females, 
ovarian and mammary substance. The usual result is improve- 
ment in nutrition, increase in growth rate, increase in blood- 
pressure, decrease of pulse-rate, and improvement in mentality. 
The thyroid should be omitted entirely or reduced to a minimum 
in cases showing the least evidence of hyperthyroidism. In this 
same class of cases of polyglandular disorder I have produced 
practically the same results in some cases by the administration 
of thyroid alone and thymus alone. Improvement following 
the administration of glandular preparations has been reported 



638 APPENDIX 

by other observers. Thus, Dana and Berkeley have reported 
the results of investigations which they carried on under a grant 
from the Rockefeller Institute. Pineal extract was fed to a 
number of defective children in whom no grave organic brain 
defect existed. They believe that the pineal gland has a definite 
and important function, viz., that it promotes the development 
of the human nervous system, and they assume that it supplies 
a minute amount of intracellular ferment accelerating the growth 
of the gray matter of the brain. While in the cases which they 
report mentality showed a steady and gratifying improvement 
lasting over the whole period of administration, such improve- 
ment, as reported, was no more marked than I have observed in 
cases treated as outlined above. It is my opinion that improve- 
ment results from the stimulation of metabolic processes by 
bringing into equilibrium the various glands with their common, 
though tangled relationship, rather than through any selective 
action upon a particular gland. 

When the symptoms pointing to one gland predominate, as in 
hyperthyroidism, hyperpituitarism, etc., the indications are more 
specific. I have known an apathetic, listless boy, who would 
take no part in the occupations of his school fellows, to be trans- 
formed in a few weeks by small doses of thyroid into a lively, 
mischievous youngster. A little girl of three years, short, fat, 
and stolid, who showed little desire to talk, was put upon thyroid 
extract with the result that her mother came to me a few weeks 
later with a request from the family that I give her something to 
stop her talking. Another patient of mine, a case of infantilism 
with symptoms strongly suggestive of hypophyseal insufficiency, 
gained one and a half inches in height in ten weeks (more, his 
father states, than he had grown in a year before) under the ad- 
ministration of pituitary gland. 1 

Kerley and Beebe 2 report a case of retarded physical develop- 
ment in a boy in which treatment by thymus extract apparently 
gave brilliant results. 

The efficiency of hormone-therapy is enhanced when it is pos- 

1 E. Bosworth McCready, "Study of a Case of Infantilism with Hypophyseal 
Insufficiency," Illinois Medical Journal, October, 1914. 

2 C. G. Kerley and S. P. Beebe, "A Case of Delayed Development in a Boy 
Treated with Thymus Gland," American Journal of the Medical Sciences, 
August, 1912. 



A MEDICAL SYMPOSIUM 639 

sible to subject the patient to the hygienic and educational 
measures which modern methods of dealing with the exceptional 
child have shown to be useful. In child-culture as in horticul- 
ture it is intensive effort which produces results. 

XVI. THE MENTALLY BACKWARD CHILD FROM 

THE STANDPOINT OF THE NEUROLOGIST 

By Doctor M. Neustaedter, New York City 

Children Far Below the Normal Standard. — By a mentally or 
intellectually defective child I mean one who is far below the 
normal standard as accepted by well-established intelligence 
tests. I say far, because in testing the mentality of a child sev- 
eral factors must be taken into consideration, namely the per- 
sonal equation of the examiner, the home environment of the 
child, hereditary influences, and lastly whether the defect is 
general or only limited to certain tendencies. Thus, a child 
found to be one or perhaps two years behind his age, according 
to a certain intelligence test, I would hesitate to call defective. 

The inability of a child to make appreciable progress under a 
skilled instructor within a period of at least two years ought to 
be an additional criterion of its mental defect. 

Concomitant Factors of Backwardness. — What are then the 
concomitant manifestations of backwardness — what are its causa- 
tive factors, and to what extent can it be ameliorated ? 

Frequently the concomitant manifestations are of a functional 
nature, such as various types of neuroses or psychoses; but in 
the vast majority of cases we find organic brain defects. Among 
the first I would include chorea, habit spasms, neurasthenia, hys- 
teria, essential epilepsy, psychical equivalent, dementia praecox, 
and types of manic-depressive psychoses. In the latter I would 
put various types of infantile cerebral palsies with or without 
epileptiform convulsions, hydrocephalus, micro- and macro- 
cephalus, cerebellar and tabetic ataxias, organic defects of the 
special sense-organs. We may also include here organic defects 
which, although not of the brain proper, are concomitant mani- 
festations of the mentally retarded child. These are the infan- 
tile dystrophies and diseased ductless glands, which latter give 
rise to cretinism, infantile myxcedema, Mongolian family idiocy, 
infantilism, Basedow's disease, acromegaly and mixed types. 



040 APPENDIX 

Etiological Factors. — The etiological factors are generally con- 
sidered pre- or post-natal. They may arise as a result of 
trauma, of an infectious process, or again be the result of 
an affect, namely, of an inherited neuropathic or psychopathic 
constitution. 

The most frequent traumatic influences are delayed labors or 
instrumental deliveries. These two factors are elicited in fully 
one-third of my cases, and that is in agreement with the reports 
of most investigators. Other forms of post-natal traumata are 
by no means uncommon and are present in the histories of cases 
attended by convulsions. I want to call attention here that 
psychical trauma, such as shock from fright, is a frequent ex- 
citing factor in the production of neurosis, and even a psychosis 
on a neuropathic or psychopathic constitution. 

Of the infectious agents, the exanthemata take the first rank. 
Cerebrospinal meningitis, poliomyelitis, pneumonia, syphilis, and 
tuberculosis are very often recorded. Diphtheria and various 
streptococcic infections of the nose and throat and middle ear 
frequently give rise to meningeal involvement. 

Both the traumatic and infectious agents produce inflamma- 
tory conditions of the meninges at the base and the convexity 
of the brain. If at the base, some of the cranial nerves become 
involved, and give rise to defects of the special sense-organs. 
Blindness will result when the optic nerves are involved, and 
deafness when the acoustic nerves are affected. Children sur- 
viving from basilar meningitis are very often deaf and blind. If 
the convexity of the brain is involved, we may deal with a 
hemiplegia, epileptiform convulsions, motor or sensory aphasias, 
either partial or complete. The ideational faculties may be 
dulled, or retarded, or completely destroyed. In cases where 
the communicating foramina between the ventricles are partially 
or completely occluded by inflammatory deposits, an accumula- 
tion of an exudate will lead to internal or external hydrocephalus. 
If the amount of fluid in the brain is sufficiently large to exert an 
undue pressure upon the brain-cortex, it is perfectly evident that 
we shall get diplegias, convulsions, and a very low mentality. 
Vision in such cases is always interfered with on account of the 
pressure exerted upon the optic tract. 

Cortical and basilar hemorrhages are frequently produced by 
traumata. They also lead to depressions of the skull, which 



A MEDICAL SYMPOSIUM 641 

press upon the brain-cortex. In these localized lesions we get 
focal symptoms in conformity with the place involved. 

In case of syphilis I distinguish between infection and affec- 
tion. In an infection by the syphilitic virus, the Treponema 
pallidum is inoculated. Such infection of the central nervous 
system will give rise to cerebral or cerebrospinal syphilis with 
focal symptoms according to the site involved. Blindness, deaf- 
ness, convulsions, paralysis, ataxias, and even psychoses may 
result. 

By an affection I mean a state of lowered vitality as compared 
with the normal threshold. This is the result of the chemotactic 
action of the toxins upon the protoplasm of the brain-cells, a 
pathological change in the normal molecular consistency. Such 
lowered vitality is inherited by the offspring without the virus 
producing such change. This affection manifests itself in what 
is commonly known as a neuropathic or psychopathic constitu- 
tion. Alcohol and tuberculosis as well as syphilis are productive 
of such conditions. It is an accepted fact that such hereditary 
taints are transmitted from generation to generation. In prog- 
enies of consanguineous marriages, in whom there are such dele- 
terious factors, these deteriorating manifestations are brought 
out more promptly and certainly. Upon such a neuropathic or 
psychopathic constitution psychic or physical traumata or in- 
fectious diseases will engraft some form of mental deterioration 
and thereby render the mind decidedly unstable if not exactly 
insane. 

Alcohol, even in small quantities, frequently used, affects the 
protoplasm and therefore the entire system. It lessens the ab- 
sorption of oxygen by the red blood-corpuscles and the exhala- 
tion of carbon dioxide, thus producing a toxic condition. It not 
only diminishes the powers of resistance but favors the growth 
of pathogenic organisms. It also inhibits to a great extent the 
metabolic changes in every organ of the body. 

The decrease or increase of mental disorders and crime are 
shown by statistics to be in direct proportion to the rise and fall 
of the consumption of alcoholic beverages. 

Since the mother has a greater share in the life and care of 
the child maternal alcoholism is of far greater danger than the 
paternal. It has been proven again and again that the earlier 
in her pregnancy a woman takes to drink the more certain will 



642 APPENDIX 

be the debility of her offspring. Among others, Bourneville 
made a close study of 2,555 children who were classed either as 
idiots, epileptics, or imbeciles, or who suffered from some form of 
neurosis, and of these he found that 1,053 had an inebriate par- 
entage. In 933 it was paternal; in 80, maternal, and in 40 it 
was traced to both; 235 were conceived during paternal drunk- 
enness. 

We may therefore conclude that parental intemperance, if 
not itself due to a neurotic heredity, and especially if emphasized 
by disease or privation, certainly produces a marked influence 
upon nutrition and causes mental and physical degeneration, 
both in parents and offspring, in other words is productive of a 
neuropathic or psychopathic constitution. 

In tuberculosis we also deal with a toxic condition that ravages 
the tissues of the parent and produces not only a diminished 
resistance to the infection, but gives rise to imperfect bodily 
development of the child. It may not be the tubercle-bacillus 
that the surviving offspring inherits, but the so-called scrofulous 
condition— a degeneration due to a toxaemia. Such children 
show manifestations due to an underdevelopment of various 
tissues, never reaching the norm, and thereby also a low threshold 
of their functions. One notices a subnormal body weight, a 
positive sign of lack of proper nutrition. The skin is spongy, 
pale, rather inelastic, and yet not tense. The muscles are as a 
rule flabby and weak, prone to fatigue easily, and to become 
exhausted. The swelling of the lymphatic glands is a constant 
accompaniment. These are constant signs of a scrofulous 
diathesis, and as the children get older they develop various or- 
ganic diseases of the viscera and bones characteristic of a faulty 
nutrition. Hand in hand with that goes a mental backward- 
ness in various degrees from a mere retardation to a complete 
imbecility. • 

Syphilitic affections, as stated before, do not yield symptoms 
of an infectious process, but rather of a constitutional inferiority. 
And yet the fate of such a child may be as dark as that of an 
infected one. Its general physical development may also be 
retarded, or even markedly inhibited. Agenesis, aplasias of 
various tissues, especially of the central nervous system, are met 
with in no rare instances. Dystrophies are now regarded as due 
to such aplasias. The cells may possess a weak power of re- 



A MEDICAL SYMPOSIUM 643 

sistance and fatigue rather early in life, succumbing easily to the 
very onerous tasks required of them in the daily discharge of 
their functions, unable, as it were, to proportionally assimilate 
new food and replenish energy as easily as lost. Many authors 
also believe that the toxins of the syphilitic virus cause organic 
changes in the various elements of the central nervous system, 
the ganglion-cells, their prolongations, and the glia-cells. The 
vessels do not escape injury altogether. An obliterating enar- 
teritis or a gummatous periarteritis with consequent areas of 
softening are not uncommon. Such is the anatomical basis of 
various juvenile psychoses. 

Finally we come to consider the diseases of the ductless glands. 
The secretions of these glands contain chemical substances which 
profoundly influence the bodily functions. According to one 
theory they enhance the assimilation of food and thereby influ- 
ence growth, and according to another one they are supposed to 
be germicidal and neutralizers of toxins, and thus are a preven- 
tive to toxic destruction of tissues. Whatever theory may prove 
to be the correct one, it has been established experimentally and 
clinically that whenever the balance of these internal secretions 
is upset by a lesion in any of these glands there result diseases 
which give rise to definite clinical manifestations. Just as the 
various organs are influenced in their nutrition, and therefore in 
their growth, so are the functions of the central nervous system 
profoundly influenced in the same ratio. All children suffering 
from any defect of the ductless glands are mentally below par. 
It matters not whether we are dealing with the hyperthyroidism, 
giving rise to the syndrome of Graves's disease, or its antagonist 
hypothyroidism resulting in cretinism, infantile myxcedema, 
or again hyperpituitarism with the syndrome of acromegaly, or 
that of hypopituitarism with the symptom complex of infantilism, 
imbecility, or even idiocy. Mental backwardness is a constant 
manifestation. Of course, the degree of the child's backward- 
ness depends entirely upon the extent of involvement of these 
glands. The particular etiology of these affections is not defi- 
nitely known, but many investigators have been able to demon- 
strate that alcohol, tuberculosis, and syphilis play a considerable 
role in their production. It may not be amiss to state here that 
enough attention has not been given to the defects of the ductless 
glands as a possible etiological factor in the production of the back- 



644 APPENDIX 

ward child. I am inclined to place the onus upon them when- 
ever I am unable to elicit any Other factor in the absence of focal 
symptoms that would point in another direction. 

Amelioration of These Conditions. — From what I have said 
before it is evident that the possible amelioration of such condi- 
tions may best be accomplished by prophylactic measures rather 
than curative. It would be impossible to enter upon an extensive 
discussion in this paper, but a few general remarks may prove 
of value. 

The education of the public in eugenics is the important phase 
of prophylaxis, but our public servants must strive to create 
ideal social conditions. The wage-earners who are the great bulk 
of the social organism should be given a chance to live in ideal 
homes as well as to make a fairly comfortable livelihood under 
ideal conditions, in the factory. 

Consanguinity in marriage should be restricted by legislation 
to a far greater extent than is done by any church or creed. It 
should be made compulsory for any one applying for a marriage 
license to undergo a thorough physical examination by expert 
observers. The Wassermann reaction should be resorted to in 
every case. 

As the production of these unfortunates is not limited to any 
particular class of society, but is the result of the outcroppings 
of vicious and defective tendencies in all ranks and classes, in- 
cluding the highest, where the black sheep of the family does 
not come merely by chance, the avoidance of injudicious matings 
of those who are utterly unfit for the propagation of healthy off- 
spring is imperative. 

So far as curative measures are concerned, they must be both 
medical and educational. Hygienic surroundings and proper, 
nourishing, and easily assimilable diet are the most important 
prerequisites, and along with them, proper medication as the 
case demands. In cases which are still amenable to medical 
treatment, this will do a great amount of good. This is especially 
true in cases of syphilitic infection. Alongside with this an in- 
dividualizing, not specializing, pedagogue, one with a keen power 
of observation and fairly well equipped with a knowledge of 
psychology and anatomy and physiology of the central nervous 
system, will materially aid in bringing order out of chaos. All 
this must be attempted early if success is to be attained, for as 



A MEDICAL SYMPOSIUM 645 

the child grows its brain-cells adjust themselves to their environ- 
ment, and to begin late would mean to attempt the impossible. 
Conclusion. — In conclusion I would say that each case must 
be studied as an entity by itself, and we must minister to its 
particular needs as the case may demand. As to the general 
prophylactic measures which I have pointed out, I would say 
that they seem to me to be very simple and not at all costly, 
and if realized by our educators, social workers, physicians, and 
legislators they would find a perplexing problem well in hand. 1 

XVII. CARE OF THE NEUROTIC AND PSYCHO- 
PATHIC CHILD 

By Doctor Frederic J. Farnell, Providence, R. I. 

Infantile Roots of Adult Psychopathy. — There is probably no 
phase of modern psychopathology so interesting or so legiti- 
mately one of general concern and attention as that which deals 
with mental development of the neurotic and psychopathic child. 
The importance of this early period of development is steadily 
gaining recognition, yet, just how far and just the reason why 
adult mental abnormalities are the distortion of memories of 
childhood experiences is still a matter of individual opinion. It 
has been stated, nevertheless, that since infantile roots are rarely 
lacking in adult mental derangements, the study of an adult 
might be viewed as " child study." 

The Make-up or Personality. — Chief among the conditions 
one must keep in mind is the period of moulding the child, ob- 
serving especially those different elements which tend toward the 
make-up or personality. A knowledge of growth is necessary for 
the understanding of the matured state.. 

Just as the personality or make-up of the mentally afflicted 
individual is the result of a process of growth, so it is in these 
types of children — the beginning of a process of growth. The 

1 Doctor Neustaedter's views differ in several points from those presented in 
this book, in the general conception of the problems of heredity and of prophy- 
lactic measures. He offers, however, from his great fund of experience, so many 
valuable suggestions and indisputable facts, that the author is happy to have 
him among his contributors. It is well, anyway, to give space here to a state- 
ment from a scientific representative of another point of view. la most points, 
he corroborates the main contentions of this volume. 



646 APPENDIX 

child must be recognized as a collection of forces, and he should 
be studied from the dynamic rather than from the static stand- 
point. 

Unconscious Elements. — One must take into consideration, 
however, inborn tendencies, impulses, and instincts. There are 
also forgotten and unrecognized psychical contents which have 
not been brought into the actual existence of the memory. 
They are in close relationship to unconsciousness; they also bear 
a relationship to conscious ideals and efforts, but owing to the 
presence in consciousness of opposite ideals and efforts they are 
repressed from consciousness. As a result of this exclusion from 
consciousness the content of the unconsciousness can be revealed 
only by its consequences. 

Early Repressions. — In the first five to seven years of a child's 
life, during which time he is almost entirely in the home receiving 
his training from his parents, associations are made which, by 
the poor co-operation of the parents or guardians, may be re- 
pressed, not only offering the possibility of an early neurosis but 
also offering seed for disturbance of his whole life. Every re- 
pression, even in a child, means a further hindrance of mental 
development. Various authors have used the term " fixation," 
or the driving and encouraging of faulty mental habits along a 
pathway which it would not otherwise have followed, especially 
so should it not meet with the interest of the child. The repres- 
sion of one mental content is naturally followed by the suppres- 
sion of other mental processes, even those which may be of use 
in balancing the individual. 

For example: Take a child who expresses himself along a cer- 
tain line — saying he has not done or said such and such a thing, 
which was later demonstrated to be a lie. Should it be regarded 
immediately as a lie, and the child punished accordingly, one 
only succeeds in demonstrating to that child the mental concep- 
tion of a lie of which he might otherwise have remained in igno- 
rance. It should be remembered that the unconscious factors in 
falsifying play a far greater role in the child mind than may be 
supposed. The punishment of such a child is liable to create 
direct antagonism toward that parent, which antagonism may 
become hatred or distrust according to the deceptions the parent 
may have given the child when he was in earnest search for truth. 
There is no question which will stimulate a query in a child's 



^ MEDICAL SYMPOSIUM 647 

mind more than that to which the answer " not to speak of such 
matters again" is given. 

Relations of Parent and Child, — It should not be at all sur- 
prising to hear the emphasis laid upon the relations of the child 
to parent or guardian; their relationship is of marked significance. 
The formation of love attachments to mother or father should 
be guarded, and the most careful attention given to the proper 
purifying of instinctive tendencies as they may become mani- 
fest. One should not be too strict or too tender with the child. 
Too much affection or too severe corrective measures may be 
influential in producing an early sensual manifestation in the 
former, or a serious disturbance in temper in the latter. With 
the former, love attachments become stronger and manifest 
themselves in later years in various peculiarities of character. 
In the latter, love attachments weaken, desires are converted 
and energy discharged in defects in conduct, such as cruelty 
toward animals or individuals. The many other psychical and 
mental abnormalities can frequently be traced to an early in- 
fantile fixation or an erroneous attitude toward a parent. 

Interpretation of Misconduct — These conditions having de- 
veloped, helpful measures should be instituted and the child 
carefully analyzed. This method of handling this particular 
type of child has met with excellent success in the hands of such 
men as Doctor Pfister of Zurich and Professor Healey of Chicago. 
It resolves itself into the interpretation and explanation of mis- 
conduct and bad behavior as faulty mental habits following early 
childhood experiences. Its value is dependent upon the uncov- 
ering and tracing back the formation of the child's character, re- 
adjusting the individual and placing such props as may be 
necessary as balancing factors. 

It is of great importance to* obtain the patient's version of the 
defect present, and then retrace its development in and out of 
the consciousness, recalling by free conversation latent memories 
and laying bare the unconscious as far back as possible, even to 
3 or 4 years of age. One never realizes the vast amount of for- 
gotten memories and experiences that can be readily and easily 
recalled through psychological analysis. 

Method of Handling Patient. — One must consider, however, 
not only the reminiscences and forgotten memories, but also the 
setting in which they occur, by the careful handling of the pa- 



648 APPENDIX 

tient's resistances and affording a proper transference whereby an 
adequate affective reaction may be obtained. This constant forc- 
ing of memories and making the individual reveal all thoughts, 
whether in relation to the initial defect or not, forces every con- 
nection in mental activities to become manifest. There is not 
merely one string of mental events to observe but many, and 
each seance adds more to the accurate guidance which is neces- 
sary to give proper weight to them. These individuals are usu- 
ally erroneously informed upon many subjects, and appear to be 
"all mixed up" and entangled in a mass of creative misappre- 
hensions. At these points a careful reversion, which as a rule 
they do not wish, is only successful by tactful questions and a 
perfect understanding of what they themselves mean, readjust- 
ing as well as possible without offering too many suggestions. 
Once they observe that their thoughts are interpreted as false 
knowledge additional resistances crop up and offer more bar- 
riers to the examiner. 

As the analysis progresses, however, the resistances lessen, 
and a time soon approaches when the unconscious thoughts flow 
freely which, with the help of dreams, allow the synthesis of the 
misbehavior or faulty mental habits. Much of the personality 
of all these individuals is below the threshold of consciousness. 

Correction of Faulty Mental Habits. — It is thus seen that by 
the process of analysis faulty mental habits may be corrected, 
the demands for certain lines of thought and action may be 
planed down to a fair degree of smoothness and that the fearful 
emotional disturbances so common as a result of inner associa- 
tions and dream states may be brought into their real light. 
These elaborate methods in dealing with the actual facts of phys- 
ical and mental experiences enable one to interpret and formulate 
adjustments in the cases of bad behavior and conduct disorders. 

XVIII. A BRIEF STATEMENT OF THE TREATMENT 
OF THE PSYCHOPATHIC PERSONALITIES OB- 
SERVED IN THOSE WHO DEVELOP DEMENTIA 
PRECOX 

By Doctor Howard A. Knox, Ellis Island, N. Y. 

Predementia Praecox. — My experience in the treatment of 
these personalities has not been extensive and it is largely theo- 



A MEDICAL SYMPOSIUM 649 

retical, but I do believe that the atypical make-up which we so 
constantly see in those who develop dementia praecox, will be 
the subject of fruitful endeavor in the future. Unfortunately 
at the present time we seldom see the individual until he has 
shown definite signs of insanity. Adjustment and an explana- 
tion of the psychic mechanisms involved is then a more or less 
useless endeavor. Any efforts of a prophylactic nature must 
necessarily be made in the stage of predementia praecox, that 
is, before the onset of a definite psychosis. 

Four Types of Personality. — We commonly see four types of 
personality quite constantly in our cases, and the first of these to 
be mentioned is of most importance and the one most commonly 
seen. They are the following: 

(i) The shut-in personality, or, as it is sometimes called, the 
seclusive make-up. 

(2) The overvirtuous, or, as they are commonly called by 
their fellows, the " goody-goody " type. 

(3) The lazy child who is lacking in energy and ambition. 

(4) The changeable or easily influenced type. 

In girls, there is often a tendency toward early immorality. 
I have called the latter type, the facile type. 

Influence of Adolescence. — Experience shows that the psy- 
chosis most often comes at the beginning of adolescence, at which 
time the individual is called upon to assume the duties allotted 
to him by nature. The shut-in type of personality is the one 
with which I have had the most experience. In these cases, the 
individual is of a retiring, bashful, uncommunicative, and lachry- 
mose turn of mind. There is often a definite mother attachment 
in the case of boys, and a father attachment in the case of girls. 
They dislike the opposite sex, do not play or associate with them, 
never have a serious love-affair, and frequently are given to 
masturbation. It may be said here that the prevailing idea re- 
garding the latter symptom is that it is of etiological importance, 
whereas it is only a symptom of the underlying condition. 

Causation and Type. — The theories of the most prominent 
authorities on dementia praecox, viz., Krapelin and Bleuler in 
Europe, and August Hoch and Adolf Meyer in this country, 
have given us by the combination of their work an excellent in- 
sight into the causation and type of individuals who develop this 
disease. The causation remains on a somewhat theoretical basis, 



650 APPENDIX 

but the personality is now a quite well-established fact, thanks 
to the researches of Hoch. 

Toxic Origin. — It seems probable, judging from the results of 
the work of these men, that dementia praecox has a toxic origin 
with a superimposed psychosis of psychogenic derivation. From 
the researches of Meyer it would seem that these persons present 
constitutional characteristics from earliest childhood that later 
develop into the usual symptoms of dementia praecox. From 
the results of Hoch it is apparent that these individuals present 
certain constant and definite traits that brand them as liable to 
develop this disease. 

Prevention of the Disease. — Starting on these premises we are 
in a position to begin to think of the prevention or prophylaxis of 
this most dreaded of psychosic entities. If the individual 'pos- 
sesses such marked prerequisites that he will develop the disease 
in spite of any measures taken, then treatment is of course use- 
less. If, however, he possesses a less marked susceptibility, we 
may hope for some results if taken early. The time for treat- 
ment is evidently in the preadolescent period. If there is a 
toxic basis for the condition, further study will be necessary to 
determine what this is. The time of onset would indicate that 
there might be a deficiency or an overproduction of the hormones 
supplied by the glands of internal secretion that are called into 
play when sex life begins. If one of these theories should sub- 
sequently be verified, the treatment would be obvious. If the 
condition depends more especially for its origin on psychic mal- 
adjustment, then explanation of mechanisms, possibly including 
psychoanalysis, might be of considerable value. It is in this 
direction that I have already made some endeavors. It will take 
years to determine whether or not these have been effective, and 
even then I shall not know with certainty that the cases would 
have developed dementia praecox if it had not been for my ef- 
forts. 

It is probable that the intelligent, ingenious neurologist and 
psychiatrist could map out a life programme for these pre- 
disposed children that would enable them to adapt themselves 
to the demands of life. It would be quite useless to ever expect 
them to marry successfully, but it might be possible to sublimate 
their energies in other channels and thereby procure harmony 
for them and usefulness for society. 



A MEDICAL SYMPOSIUM 651 

It seems to me quite reasonable to believe that a much earlier 
residence in a well-conducted institution might be of service, in 
other words, that if the predisposed person could be selected 
with certainty and turned over to competent medical men and 
placed in the well-ordered routine of a first-class institution, free 
from the strifes and cares of the world, they might be tided over 
the dangerous period and saved to themselves and their friends 
and thus spare the State the burden of the expense of their in- 
carceration and their friends the sorrow incident to their plight. 

I offer these suggestions as much in the hope that they may be 
the basis of fruitful research as I do in the hope that they may 
benefit the individual prepsychotic. To those interested, the 
works on dementia praecox of the above-named psychiatrists 
are recommended. 



XIX. THE MEDICAL TREATMENT OF 
EXCEPTIONAL CHILDREN 

By Doctor Tom A. Williams, Washington, D. C. 

Causes of Deviation from Type. — Deviations from type may 
be due to the peculiarities of the germ plasm (i); or may be the 
result of disease after the formation of the embryo, no matter 
whether before or after birth. 

Those differences from the normal which are occasioned by 
the actions of parasites, or caused by gross injuries will not be 
considered in this paper; for to do so would require text-books 
on medicine and surgery. To consider in detail the anomalies 
of the apparatus of vision, hearing, posture, digestion, and nu- 
trition in children would not be possible in this volume. What 
is most necessary to be said on these subjects is presented in 
other contributions to this symposium. 

What is not well considered in text-books on pediatrics is the 
psychopathology (2) of the child; and the directions concerning 
the physical hygiene of the neurotic child are usually perfunctory, 
conventional, and guilty of sins both of omission and commis- 
sion, especially regarding study, exercise, play, and food. 

Accordingly, there will be considered in this paper: 

First : Some of the physical causes which produce neurotic 
behavior. 



652 APPENDIX 

Second : The chief psychological sources of disturbance to 
child life. 

A. Physical Causes: 

I. Insufficient air and improper clothing, viz., too tightly 
fitting. 

II. Incorrect food and drink. 

III. Inadequate or improper exercise of body. 

IV. Imperfect elimination. 

V. Disordered glandular action. 

B. Psychological Causes: 

I. Mismanagement of attention. 

(a) Inconsequence of thought and action, self-control, sug- 
gestibility. 

(b) Its contrary: oversustained attention. The sequences. 

II. Mismanagement of emotion and sentiment, desires and 
inclinations. 

(a) Intemperance. 

(b) Its contrary: overrepression. 

(i) Affection. Altruism. Religiosity. 

(2) Anger. Pugnacity. Sulkiness. Hatred. Dislike. 

(3) Fear. Anxiety. Scruples. Obsessions. Shame. 

A. Physical Causes. — I. The Air. — Fretfulness after meals 
or after play is very often due to the improper atmosphere sur- 
rounding the child. It must not be forgotten that the heat pro- 
duction in a child is very active, and his need for oxygen much 
greater than in the case of the adult. It is only prolonged ex- 
posure which is dangerous in the case of children. But even the 
chilling of the extremities by exposure may not be detrimental 
if the trunk, especially the abdomen, is kept warm. The sen- 
sations of a sedentary person with poor oxidation are a very poor 
guide to the qualities of the atmosphere to be breathed by young 
children. 

The thermometer is, of course, no guide, as a warm air may be 
quite pure, and a cold air may be most noxious. Perhaps the 
best guide is the sensation of a sensitive individual returning 
from brisk exercise in the open air. If foulness is noticeable to 
such a person, the atmosphere is injurious to a delicate child. 
The best way to secure proper ventilation is the opening of win- 
dows from the top, with cross ventilation. Many of the mechani- 
cal installations for changing the air are adequate only when a 



A MEDICAL SYMPOSIUM 653 

small number of persons are present. They are incapable of 
dealing with the discharges from a crowded room. 

People who pooh-pooh what they call the fresh-air fad should 
have their attention directed to the great advantage of the open- 
air cure of tuberculosis, pneumonia, and run-down conditions. 

II. Incorrect Food and Drink. — Some of the essentials of a 
healthy dietary are lacking in the regime of a great many chil- 
dren of our day. 

To insure sufficient bulk in the intestinal canal an adequate 
amount of solids must be taken. If this is solely composed of 
digestible material, far more nutriment than can be advantage- 
ously assimilated must be consumed. 

Now, much of the food given children has been deprived of its 
indigestible constituents, the husks of fibre and cellulose. We 
are in the age of pap. Hence the child to get enough bulk eats 
too much. The sophistication of the food, furthermore, deprives 
the child of the opportunity to exercise its teeth; in consequence 
the jaws and blood-supply of the teeth are imperfectly developed, 
and caries is apt to ensue. (Sim Wallace.) 

But there is a third disadvantage of what is literally an emas- 
culation of food. In the process of refinement unfortunately 
the food is deprived of mineral salts, especially phosphates, and 
what are known as vitamines, that is to say, protein (3) materials 
in very minute amounts which are necessary complements of the 
larger amount of better-known constituents in nitrogenous food. 

In consequence of the sophistication of the cereals, reliance for 
body growth is placed upon eggs and meat, and in the earlier 
years on milk. The objections to these foods are not only eco- 
nomic. Flesh contains considerable purin-producing (4) material 
and putrifies easily. Eggs rapidly undergo poisonous disintegra- 
tion, and the albumen is too concentrated to be a good food for 
a species which is constituted as a mixed feeder. Milk is a food 
only for babes, unless especially prepared. 

The best diet for a neurotic child, or any child for that matter, 
is a plentiful supply of such cereal foods as are prepared from 
entire wheat and oats, supplemented by an abundance of fruit, 
especially the banana, the sugars of which supply energy easily, 
and the saline constituents of which favor the rapid metabolism 
of childhood. The proteins of Indian corn, barley, and rice are 
not in themselves sufficient for active growth, but must be sup- 



654 APPENDIX 

plemented by others, such as are found in wheat or oats, or in 
flesh, eggs, and milk. 

We are just beginning to learn about the intimate constitu- 
ents of some of the proteins. Further study should enable us 
to substitute for the inadequate corn and bacon ration of the 
farm something less expensive than the abundant mixed dietary 
which is now being used in treating pellagrins. For instance, the 
nutritional disease beri-beri can be prevented by the addition 
to the food of an infinitesimal dose of a substance obtained from 
rice bran, although the disease otherwise occurs in persons fed 
on milled rice. 

The psychology of children's appetite, inclinations, and fads 
about feeding is very important, and will be considered in the 
section on psychopathology. 

III. Inadequate or Improper Exercise. — Rickets, usually re- 
garded as a nutritional disease, is by some thought due to lack 
of exercise of poor children in cities kept off the streets for fear 
of accident; or of richer children paraded in perambulators by 
thoughtless mothers. All young mammals exercise very actively; 
it is in their play that they develop. Children in cities, however, 
have so many inducements that they are apt to fall into sedentary 
or loafing habits. Hence it is important to somewhat system- 
atize and supervise the play of children in these days; for on ac- 
count of the restrictions of civilization their play has to be some- 
what artificial, and is often too complex for the child capacity 
to manage. Sad to relate, it has become difficult for the child 
to play; and the difficulties are sometimes too great to surmount 
except by the most adventurous spirits. These facts are espe- 
cially important for the parents of an exceptional child; for to 
these handicaps will be added the stresses of adaptation to his 
fellows whose unlikeness to himself may still further discourage 
his inclination to play, and thus prevent the proper exercise of 
his body. 

Not the least important function of exercise and play is its 
value in psychological development. This will be discussed in 
the section on psychopathology. 

IV. Imperfect Elimination. — Constipation, as is well known, 
has serious consequences. To avoid these, drugs which stimulate 
the movements and secretions of the intestines have been 
greatly used. The relief afforded by them is so rapid that the 



A MEDICAL SYMPOSIUM 655 

laity — and many physicians — have shortsightedly countenanced 
the frequent use of aperients, seeking only to find one which 
will have no weakening effect on the bowel. Of course, such a 
purgative does not exist, because every artificial stimulation 
must be followed by a reaction which makes the condition of 
affairs worse than before. For a long time cascara sagrada was 
preferred, having superseded the rhubarb of our grandmothers. 
Now the fad has become Russian mineral oil, recognition of the 
failure of cascara now being general. The objection to mineral 
oil is that it prevents the access of the digestive fluids to the 
food particles by coating them with an entirely insoluble sub- 
stance. If purgation by lubrication is sought, an organic fat, 
such as olive-oil or cream, is very much better. 

But the proper way to prevent constipation is to adopt the 
principles given in the paragraphs concerning food and drink. 
For such principles give a proper residue with which to distend 
the intestine without at the same time furnishing an amount of 
putrescible matter much greater than can be rendered innocuous 
by the digestive juices. 

The most important eliminating organ is the kidney; but when 
this is disordered a physician must be consulted. 

Elimination by the lungs takes care of itself if proper air is 
provided and clothing is not too tight, and if the respiratory pas- 
sages are kept free. This demands examination of the nose and 
the back of the throat by a physician, and the escape from catarrh 
by good hygiene and the avoidance of contact with persons in- 
fected with catarrh. 

Elimination by the skin is favored by proper bathing and 
changes of clothing, and the avoidance of too closely woven or 
heavy underclothes. Regarding bathing, indiscriminate advice 
has done much harm. The morning cold bath, erected into a 
fetich in England, does much harm to some constitutions. The 
danger of chill after a tepid bath is very great; but if a bath is 
taken very hot and remained in until the skin is thoroughly per- 
meated by the heat, leisurely cooling while dressing will prevent 
active perspiration which would cause liability to chill. The 
delicate child or neurotic child is unusually susceptible to the 
effects of heat or cold, or both, and his bathing habits should be 
determined upon only after careful observation of his constitu- 
tion, preferably by a physician conversant with nervous children. 



656 APPENDIX 

They should not be imposed arbitrarily according to a hard-and- 
fast rule. The same remark applies to bathing in the sea or 
river. For while nothing is more beneficial even to a nervous 
child than swimming, yet some children are quite incapable of 
withstanding the great vasomotor strain of sea-bathing in such 
a temperature as is afforded by the coast of Maine or the North 
Shore of Massachusetts. 

V. Disordered Glandular Action. — The relation of the glands 
of internal secretion to the functions of the nervous system is 
very important. We know already a great deal about the thy- 
roid, adrenal, pituitary, the thymus, and the parathyroid glands 
in relation to nervous disorders. The consideration of the sub- 
ject is, however, very complex and a purely medical matter not 
suitable for a full discussion here. 

A few remarks, however, may show the kind of symptoms 
which should lead to medical consultations for the child. 

Pituitary Disorder. — A girl of n (Case 82) was brought by 
her mother because of loss of interest in her lessons, of which she 
had previously been very fond; grimacing of the face in spite of 
all corrections; equivocations and fibbing in attempts to evade 
her duties, and greediness amounting to gluttony. She had 
always been a stout child, but had become enormous during the 
preceding year or so. 

Exploration of a possible psychological cause for this change of 
behavior was fruitless; so psychomotor exercises were begun 
for the facial tics. The only effect of these was to arouse the 
patient's resentment, and they were not persevered with. 

Some time after, great somnolence manifested itself, the child 
becoming very lethargic and even dropping off to sleep in the 
middle of a task or at the table for a few moments. 

This directed attention to the function of the pituitary gland. 
So this was immediately explored by the levulose test. As this 
showed great increase of the tolerance of the system to large 
amounts of sugar, it was decided that the pituitary gland was 
functioning insufficiently: great increase of weight, torpor, 
psychic inadequacy and its attendant changes in behavior being 
symptoms of lack of pituitary secretion. Feeding with increas- 
ing doses of pituitary gland was at once begun. 

The child recovered completely in a few months, and after 
the onset of puberty was able to dispense with the pituitary 



A MEDICAL SYMPOSIUM 657 

gland; now four years later she is active and comparatively 
thin. 

Thyroid Disorder. — Excessive secretion by the thyroid gland 
causes restlessness, excitability, moist skin, rapid heart, and 
malnutrition. It is apt to occur in a slight degree near puberty, 
and although it may disappear spontaneously after that, it often 
persists. Thus it is only prudent to take medical advice when 
the foregoing symptoms appear in one's child. 

Deficiency of thyroid secretion is shown by many symptoms, 
the most noticeable being sluggishness of body and mind, coarse- 
ness of body and hair, thick voice and stunted growth. Cretin- 
ism is only an extreme degree of this. Hypothyroidism, as it 
is called, is easily met by feeding with the thyroid glands taken 
from animals and appropriately prepared. 

Adrenal Disorder. — What is commonly called weak circula- 
tion, cold extremities, incapacity for severe exercise or sustained 
work, and a general feebleness with lowered resistance to infec- 
tious diseases and other causes of illness may arise from a defi- 
ciency of the adrenal gland. In case of any such child this pos- 
sibility should be carefully looked for by a physician conversant 
with the symptomatology of the diseases of the suprarenal 
gland. 

Thymus Disorder. — Children subject to croup, of pale, flabby 
constitution, poor resistance to infections and poisons, and apt 
to die suddenly during ana^sthesis, show an enlargement of the 
thymus gland, a condition which can be quite successfully dealt 
with medically. 

B. Psychopathology. — I. Mismanagement of Attention. — 
Attention is directed by motive, and motive is excited by inter- 
est. In beings without memory, such reaction as movement, 
interest, attention, are each subject to immediate activation by 
whatever presents itself. The power of recollection enables 
experience to be utilized in the accumulation of motives or inter- 
ests. These are simply the selection from the environment, of 
the activities of which, of course, thought is not the least. What 
interests shall be sought is a choice determined by two kinds of 
factors. The first of these is inherited disposition which will 
not be considered here as we are now concerned with children 
already born, and not with eugenics. The second factor of 
choice comprises the influences which shape behavior, more es- 



658 APPENDIX 

pecially those exerted in early childhood. In human beings these 
are of paramount importance, although they are innumerable 
and often unmanageable. Still in the degree to which they are 
understood and scientifically utilized do we have a proper edu- 
cation as against a haphazard one, which, however, is sometimes 
successful by virtue of the child subjected to it being influenced 
by episodes which determine his course in fruitful direction. 

The character of the individual is a composite of psychological 
trends, and each of these is acquired by virtue of the cultivation 
of the attention toward each. 

A young infant will follow any bright object placed before it 
or any sound; an earnest student concentrated on his task does 
not notice the noises in the street, nor the moving objects there: 
his attention is elsewhere, as we say. 

A boy, even though preferring to think of what is going on in 
the playground, yet keeps his mind on his task from a more 
powerful motive, no matter whether this be a desire for accom- 
plishment, or a fear of failure or punishment. I need not enlarge 
upon the familiar directing of the inclinations away from pleasure 
which is comprised in the accomplishment of the tasks required 
for the cultivation of a handicraft or profession. 

But in the case of very young children the need of direction 
of the attention and guiding the inclinations is even more im- 
portant. 

It is to the ignorance or neglect of this principle by parents 
that neurotic behavior is often due. 

The degree to which cultivation can be carried by an intelli- 
gent direction of attention is illustrated by the famous case of 
John Stuart Mill (Case 14) who could read Greek when 4 
years old, and could have entered the university at 6, in conse- 
quence of his father's ingenuity in interesting him in subjects 
usually studied at a much later time of life. That Mill was not 
a " lusus naturae " he himself frequently affirmed. This we can 
readily believe as modern instances are not uncommon. Most 
people are familiar with the story of William James Sidis (Case 
40) who knew much of human anatomy at 6, entered Harvard 
at 11, and is professor of mathematics at 18. 

The manifold accomplishments of Winifred Stoner (Case 18) 
are familiar to newspaper readers. Young Wiener (Case 17) is 
only another among many American instances of to-day. Quite 



A MEDICAL SYMPOSIUM 659 

apart from the advisability of such precocity, they all were pos- 
sible by virtue of the same principle, viz., a directing of the atten- 
tion and interests. They go to show how very ductile is human 
material. 

Results of Inattentiveness ; Hysteria. — In the absence of direc- 
tion of attention the child wanders from matter to matter aim- 
lessly. The misfortune of this is not so much the lack of learning, 
but the fact that he does not learn to concentrate his atten- 
tion, and to master a temporary disinclination for the sake of 
an ultimate satisfaction. Study in a child is of far less value for 
the material gained than for the habits of thought acquired ; not the 
amount, but the method is the important matter. A coherent, con- 
sistent plan for mentally occupying the child is particularly im- 
portant if he is neurotic, especially if hysterical in tendency. 

This word (hysterical) is used to denote the type of individual 
prone to uncritical acceptance of the environment, and in con- 
sequence easily influenced, in a word: oversuggestible. Such 
persons later in life become prone to imaginary ailments; for 
these, they are apt to seek relief at the hands of charlatans. 
They comprise a large part of the following of the new move- 
ments in which shibboleths so often take the place of thought. 
If there is a pragmatic sanction for a cult of this kind, it is sure 
to attract a large number of these uncritical individuals, for most 
of these belong to the class of " practical," unimaginative people. 
That is to say, their imaginations remain crude, lacking breadth 
to develop a cultivated imagination like that of the poet, states- 
man, or man of science. 

It is by suggestion, of which imitation is one avenue, that vari- 
ous fads and dislikes concerning food and drink are acquired. 
The following case is an illustration of the degree to which ideas 
can carry even a child to whom, as a rule, the appetite for food is 
paramount. 

Hysterical Anorexia. — In January, 191 2, a child aged n (Case 
83) was referred by Doctor Jung, who had been treating her be- 
cause of dyspepsia and a capricious appetite. During the pre- 
ceding three years she had left school three different times be- 
cause of her health; the only occasion on which a definite disease 
had occurred was six weeks before she was sent to me, a slight 
operation upon an infected corn. After this she had been dieted 
by Doctor Jung, and seemed to improve for about two weeks; 



660 APPENDIX 

but during the week preceding my consultation she had lost one 
and a half pounds. 

Anamnesis. — Upon going to bed she feels sick and weak, and 
pains shoot all through her. She has had a constant headache 
for several months. When she feels ill, she is very peevish; and 
she felt homesick for playmates as she had made no friends in 
Washington, where she had only been a few months. Instead of 
playing she sat or lay about most of the day, feeling too tired to 
fetch her books for reading, of which she was formerly very fond. 
She had also been fond of games formerly. She had had glasses 
since the age of 8, but had not worn them until lately. Her ap- 
petite was very poor. 

Examination. — Showed rather feeble reflexes. Motility less 
vigorous than normal, especially in the ankles; the feet flat, but 
not pathologically so. Unskilful diadocokinesis; a tic of the 
shoulder; and much wriggling; normal sensibility. 

Psychologically there were no intellectual abnormalities nor 
marked emotional reactions except that the little girl wept when 
it was proposed to take her away from her mother and father to 
the hospital. The mother had been very conscientious in her 
upbringing, and this had reacted on the child before whom far 
too much attention had been shown regarding both manners 
and physical welfare. Conversation before her would frequently 
concern the appropriateness of different foods and their digesti- 
bility, and the atmosphere of the home was one of solicitude 
about the child's health. 

As an infant, she was not retarded; she had been apt in school 
except in writing, when her hands would jerk; but they did not 
do so in sewing, in which she was skilful. Her bad writing in 
school disturbed her, and she would become " hysterical." Res- 
piratory infections were easy and frequent, as was the case with 
her father. Perhaps this was accountable to mouth-breathing; 
for this, adenectomy was done when she was 8. 

Diagnosis. — As Doctor Jung assured me that the stomach 
functions were performed quite well, and that he could detect 
no physical disorder of the digestive apparatus, and as the con- 
dition for the implantation of an idee fixe was apparent, and as 
conversation with the child herself corroborated my suspicion 
of this, it was evident that we were dealing with a case of hys- 
terical nosophobia. By this is meant a fear of disease implanted 



A MEDICAL SYMPOSIUM 661 

by suggestion, a matter very easy in young children and uncriti- 
cal people in general. But it is quite exceptional for food and 
appetite to be the subjects of a phobia in so young a child; for 
in the child the vegetative functions and instincts are usually 
paramount. 

While in Paris in 1 906- t 907 I saw one other case of this type 
of false gastropathy in a young child (published by Dejerine 
since). 

Treatment. — She was sent to the hospital on account of the 
nosophobia from which she suffered, the result of too much 
sympathy at home. When her parents left her she wept bit- 
terly; but she was soon cured by being made to breathe in quad- 
ruplets and by a little jollying. She promised she would try to 
behave properly if her parents were allowed to visit her. The 
promise that thev might do so stopped the weeping for twenty- 
four hours; the visit was postponed, however. She was encour- 
aged to play with another little girl patient; and this she came 
to enjoy so much that she ceased to ask to go home. When she 
had become quite contented and happy she was allowed to re- 
turn home, where she has remained well ever since. 

The treatment in the hospital consisted of creating an atmos- 
phere round the little patient designed to show her how trivial 
were her own preoccupations about what she should eat as com- 
pared with the real suffering and disabilities of the patients round 
her in the ward. Of design she was placed in the open ward in 
preference to the private room. She was shown to what a de- 
gree her feelings and behavior were under her own control, and 
no solicitude was shown about whether her food would agree 
with her or not. 

It is not possible to set down in detail the numerous measures 
used to destroy the inconvenient suggestions to which she had 
been subject so long. While the therapeutics inevitably con- 
tained a modicum of suggestion, yet the end worked for was 
always the giving of a rational understanding to the little pa- 
tient of why her symptoms had occurred, and how to prevent 
them in future. In other words, the modus operandi was per- 
suasion and re-education. Toward this the hospital furnished 
a valuable aid, but not merely because it was a hospital, but be- 
cause the nurses were intelligent coadjutors of the case. The 
child had been too much derationalized to have been manageable 



662 APPENDIX 

by office consultations alone, unless the mother had been able to 
collaborate, which she was unable to do, not from lack of intelli- 
gence or conscientious desire for the good of her child, but because 
she had not understood the psychological mechanism of her 
daughter's illness. The mother's re-education was much more 
readily effected when uncomplicated by the child's presence. 
Its success was shown by her successful management of the child 
when she returned home, for eighteen months later there had 
been no further trouble. 1 

Why a Child's Mind Needs Work. — Because they fear to over- 
burden the child mind, parents hesitate to institute systematic 
education of very young children. As a matter of fact, proper 
mental labor is needed for sound psychic health. Physiologists 
know that a disused organ is more liable to disintegration, or to 
become diseased, than one which is regularly used. I need not 
expand what is an axiom. 

But an impression prevails that growing organs should not 
be subjected to work. This is a gross error, for organs which do 
not work cannot grow well. Even the bones become tough, 
hard, and large in proportion to the stresses to which they are 
subjected by frequent and vigorous pulls where the muscles are 
attached. The comparison of the average male skeleton with 
that of the average female strikingly illustrates this fact. But 
proper development is possible only during the period of growth, 
the growth in adult structure being relatively slight however 
great is the exercise of function. What is true of structure is 
true of functional power. From ballet dancers to violin virtuosi, 
artists must be trained from early youth. It may be objected 
that this is so because muscular agility is required, but triis ob- 
jection is only superficial, for the dexterity of an artist is made 
possible not merely from superior co-ordinations of movement, 
but by means of the superior speed and accuracy of the guiding 
mental processes which reside in the brain. 

Now, as intellectual dexterity is also a function of orderly 

1 The child here described is plainly one of the atypical group as described 
in the classification underlying the argument of this book. It was fortunate 
that the nurses in the hospital where she was placed were intelligent and willing 
enough to deal with the educational problem intrusted to them But such a 
case is certainly a problem of re-education, in co-operation with psychiatric 
treatment. It is for cases of just this kind that special educational work, as typ- 
ified by the work done at Herbart Hallos particularly needed. — M. P. E. G. 



A MEDICAL SYMPOSIUM 663 

functioning of mental processes seated in the brain, it should 
be manifest that these, too, should reach excellence best when 
they are trained by a capable hand during the formative period 
of early youth. 

To Learn to Concentrate Keenly, Games Are the Best. — There- 
fore, the first fault to avoid in order to prevent neuroticism, is an 
inattentive slovenliness of thought and act. 

The finest of all means for developing the power of attention 
in children are exercises and games, more especially the latter; 
because, if properly conducted, they counteract slipshod ways, 
and make for an efficiency the results of which are evident at 
once, giving a satisfaction which sustains the attention. But 
even games can be psychologically harmful if they are allowed to 
deteriorate into an inattentive go-as you-please without zest. 

Active play stimulates attention in two ways: firstly by the 
interest and by the pleasure of accomplishment; and secondly 
by the emulation of others. On account of that very interest, 
however, games must be used moderately, and as a means to 
an end, or they will speedily dwarf in the child's mind his inter- 
est in more directly useful accomplishments. 

The social function of play will be spoken of when the inclina- 
tions, altruism, anger, and anxiety are discussed. 

Over sustained Attention. — Every athletic trainer knows that 
staleness supervenes when an athlete is taxed beyond a certain 
point. To be stale or overdone is the colloquial expression 
for what physiologists would call fatigue. Now, psychologists 
have by experiment proved that attention is very quickly 
tired; and the more intense it is, the sooner it fags, even while 
interest is maintained. Pedagogy shows the futility of prolong- 
ing children's work beyond certain hours even for the sake of 
the work itself. For the sake of the child's health, physicians 
have long pointed out the inimicalness of artificially stimulating 
the interest of a fagging child. 

Just as detrimental to concentration of attention as is the lack 
of training is the exhaustion ensuing upon an effort too sustained 
for the child's capacity. The maximum concentration is only 
possible for a very short period, and even then is proportionate 
to the favorableness of the conditions both bodily and psychologi- 
cally. For instance, it would be very wrong to compel a child 
to practise concentration while his energies are engaged in the 



664 APPENDIX 

digestion of a heavy meal, or immediately after strenuous mus- 
cular activity, or when in need of sleep. None of these well- 
known dangers would be incurred by wise parents of a neurotic 
child. 

But there is another aspect of overprolongation and insistence 
upon the attention of a nervous child; that is, the cultivation of 
an overnice or scrupulous manner of performance and of thought. 
The development of this quality becomes interwoven with the 
deepest feelings of the personality; in consequence, its avoidance 
had better be considered after we have discussed the relation of 
the feelings to neuroticism. 

Over intensity. — Eagerness and overintensity not only exhaust, 
but frequently lead to ineffective effort, a kind of stammer of 
movement, a lack of directness and precision. Of course this 
physical expression in movement is only reflection of the action 
of the brain which is the director of the movements, which are 
merely the index to wavering thought. The remedy for this 
condition is to insist upon deliberateness and system both in 
play and work. The practice of musical exercise is especially 
beneficial in teaching steadiness at gradually increasing velocity. 
The practice of recitation from memory, or the systematic rela- 
tion of incidents which have happened is another useful method 
in the correction of this defect. 

Overeagerness may lead a child to neglect his meals and sleep, 
so that even when there is no mental stammer, and there is a 
high degree of dexterity at work and play, yet nervous instability 
ensues on account of imperfect repair of waste. For example: 

A boy of n (Case 84) was brought by his mother because of 
grimaces and nervous movements which she knew presaged a 
breakdown such as he had had twice before on account of which 
he had to spend two years away from school, rusticating. He 
was a boy of extraordinary capacity, far exceeding others of his 
age in all athletic sports, and when at school immediately spring- 
ing to the top of his class. Conversation showed that he was 
no mere parrot, but had both common sense and poise. He even 
recognized his own overintensity, but his ambition made him 
unwilling to lay much stress upon it from fear of being kept 
from school and athletics. 

His good sense was shown by his retaining a friendly attitude 
even though forbidden the competitive athletics which he loved. 



A MEDICAL SYMPOSIUM 665 

This, however, was perhaps the easier as the other restrictions 
were minimal, consisting merely of a modification of the diet to 
make it accord with the principles already spoken of in the pre- 
ceding part of this article, and the enforcement of a half-hour 
period of complete rest after meals. The object of this was two- 
fold. First, to secure repose for digestion; and secondly, in- 
directly to prevent hasty eating, as when he could not go out 
immediately after dinner nothing was to be gained by bolting 
it. These simple measures produced astonishing results, the 
grimaces all disappearing, and the boy acquiring much greater 
stamina. 

This boy's father is of the same temperament, a type whose 
mental processes aie very much more rapid than the average 
individual's, so that in the same space of time two or three times 
the usual amount of work can be accomplished, at a correspond- 
ing expenditure of nerve- force. 

These persons are nearly always subject to insomnia. This 
is not due to worry, not even to a desire to think for the pleasure 
of it. It is because the energies have been so actively deployed 
toward the cerebrum that the body processes cannot settle down 
to the resting pace. The condition is quite similar to that pro- 
duced in most people by tea or coffee It has, of course, a purely 
physical basis, and is very likely due to an overabundance of 
substances of internal secretion which activate the tissues as we 
know is done by the products of the thyroid gland, the adrenal, 
and the pituitary body. 

In this variety of exceptional child there is need of very special 
treatment in the direction of shorter hours of work, and great 
attention to nourishment and repose. If this is not secured, 
the vitality needed in the struggle of life will be dispersed pre- 
maturely, and the individual will fail to complete his undertakings 
from lack of stamina. 

II. The Mismanagement of Emotion, Sentiment, Desires and 
Inclinations. — (a) Intemperance. — An emotion is an involuntary 
reaction within the body itself without reaction upon the envi- 
ronment. For instance, the word pathos expresses the idea of a 
suffering of the subject without any external action. This ap- 
parent difference between emotion and action has an anatomical 
foundation; for motion is accomplished by contraction and re- 
laxation of muscles in which the protoplasm (6) is arranged in 



666 APPENDIX 

layers across the grain, and it is subject to direct control by what 
we express as the will; whereas emotion is accompanied by con- 
tractions and relaxations of non-striped muscle which moves 
only such tissues as the coats of blood-vessels, the walls of 
stomach, intestines, and other organs, the roots of the hair, the 
substances contained in the cells of the glands. So much is this 
so that the feeling derived from these movements is to some psy- 
chologists the emotion; and a person without these structures 
would feel no emotion even at the most distressing circumstances. 
But while the reaction of emotion cannot be influenced directly 
by willing it, yet it is for practical purposes under the influence 
of the central nervous system, that is to say, through the im- 
pressions received by the senses, the sensations of which are by 
association elaborated into perceptions on account of the memory 
of similar allied, contiguous, or contemporaneous sensations. 
These are abstracted into what we call ideas, and the process of 
elaboration is called thought. 

Now, every sensation is either pleasurable, painful, or indiffer- 
ent, and likewise is each percept, idea, and process of thinking. 
The chance of any of the latter being entirely indifferent is very 
small. The feeling toward a thought is a species of emotion 
known as feeling tone. It is a practical axiom that the feeling 
tone depends upon the thought of that moment, and is a con- 
densation of the numerous feeling tones concomitant upon the 
episodes of which that thought is the abstraction. Which ele- 
ment of a thought shall preponderate is a matter of attention; 
and as each thought has its sombre and bright elements it may 
be made capable of affecting the feelings either pleasantly or un- 
pleasantly. The popular expression. " looking at the bright 
side," has a real psychological foundation. By deliberate at- 
tention to the ugly or distressing aspect of the recollection of 
an episode, pessimistic feeling is readily induced along with its 
various bodily reactions, muscular relaxation, shown by sagging 
back and shoulders, drooping mouth, slow movements, lack of 
ambition, the interference with digestion and assimilation, show- 
ing themselves as indigestion, constipation, slowing of respira- 
tion, and interference with the internal secretions of the body. 

On the contrary, if attention is focussed upon the pleasing or 
beautiful elements in the concept, a feeling of satisfaction is en- 
gendered shown by bright eyes, radiant face, brisk step, active 



A MEDICAL SYMPOSIUM 667 

breathing, good digestion, and enterprising mind The degree 
to which the way of looking at things can affect one's judgment 
is illustrated on a large scale by various associations of optimists 
whether these band together under a religious aspect or not. 

Shakespeare has made Hamlet say: "There is nothing good or 
bad, but thinking makes it so." This is not a mere phrase. The 
effect of the way of looking at things upon the bodily reactions 
is most profound as has been proved beyond refute by most 
carefully controlled experiments. 

Pavloff by his experiments on the dog proved that merely 
showing him the whip would suppress the flow of gastric juice. 
The dog was a victim of his imagination, and became ill to the 
extent of an incapacity to secrete gastric juice, which means very 
ill indeed. In fact, psychogenetic physical illness of this kind 
may reach such a degree as to cause death, as has been experi- 
mentally shown by Crile and others. 

The sufferings induced by the " gnawing fox " of the Japanese 
are made possible only by a deeply rooted belief in its existence. 
For example, a woman (Case 85) after labor declared she felt 
the " fox coming"; this was her interpretation of the after-pains 
she felt. The great parade of the neighbors in attempting to 
prevent the " fox's " attack only reinforced the patient's appre- 
hension, and soon a horrible convulsion signalized her seizure by 
the fox. Terror and convulsions held her until the exo reiser 
was called. He declared that the fox would leave her at four 
o'clock the next day provided certain offerings were placed on 
a certain tomb for it to eat. This simple suggestion caused her 
to dismiss her terror suddenly at the hour designated. The 
crudeness of the mechanism (7) in the case of this ignorant 
Oriental need not make us smile, for some of our Western cases 
are very little better. 

The following case illustrates the mechanics of tics (8) and in- 
somnia by suggestion. 

A child had a series of tics consisting of smacking the lips 
(Case 86) and bending down, touching the floor, resulting from 
her desire to avoid hurting others with her breath which she be- 
lieved was noxious, and to avoid hurting the floor with her hard 
heels. Therefore, she applied the " healing kiss " to the air 
which she expired, and the " healing touch " to the floor. After 
these had been removed through sanatorium treatment she was 



668 APPENDIX 

thought to be too nervous for school, especially as she could not 
sleep for hours after her mother attempted to teach her. In 
reality this child was not " nervous " at all. She was neither 
apprehensive, nor fidgety, nor irritable, nor of a difficult tem- 
perament. She had stayed awake by suggestion, because her 
parents had let her see that they were afraid of it. The matter 
was explained to child and parents, and in consequence of the 
step thus taken the child has attended school. She remained 
perfectly well ever since. 1 

The seeming excessive reactivity of people who feel emotions 
deeply is not direct, but merely because the emotion gives a more 
imperative aspect to the notions in consequence of which they 
act. If the action is intemperate it is not so much because the 
emotion is so as because the ideation is not adequate to form 
proper judgments. 

Hysterical Phobia. — For instance: A boy of 8 (Case 87) was 
sent to me because he was subject to " fits," previously diagnosed 
epileptic, which consisted of sudden attacks of fright, and the 
imperative desire to rush away. I soon discovered that this 
was due to his fear of wild animals, induced by the general tim- 
orousness inculcated by a foolish mother, who developed in him 
a timidity which was the source of his impulse to run away. A 
simple explanatory talk and some psychomotor (9) exercises 
showed the boy how to obtain control; and after the interview 
he recovered completely from the consequences of his morbid 
fears. This case illustrates the fact that even in children a 
realization of the situation is the important thing. It is only 
when a patient can intelligently interpret the symptoms of a 
psychogenetic (10) disorder that he is in a position to cause them 
to disappear. The patient does not get well from the analysis, 
but because of the psychic procedure adopted therefrom. The 
reason this boy ran away was because he thought there was a 
wild beast; both the emotion of fear and the action of running 
away were natural enough from the premises. The fearsomeness 
of his surroundings had been inculcated by the attitude of an 
unwise mother. 

Emotions. — The most incommoding, and often dangerous, of 

1 The case is fully described in my paper "Psychogenetic Disorders of Child- 
hood," in American Journal of Medical Sciences, 19 12, and in Journal of Abnormal 
Psychology, 191 2. 



A MEDICAL SYMPOSIUM 669 

all the emotions is fear. In the case of the boy just related, it 
was the induced fear which caused him to rush away. The 
whole psychology of fear would take too long to amplify here; 
but as it is the foundation of most of the disturbances known as 
psychoneuroses (u) to which the neurotic child is most subject, 
it is necessary to consider its prevention. Perhaps this is best 
done by an illustration and the commentary upon that. 

The formation of a night-terror (12) was nipped in the bud 
in the case of a boy a^ed three and three-quarters (Case 88). 
For several weeks he had been visiting the zoological garden 
every afternoon in the company of a French maid of exception- 
ally forceful character, and apparently free from the superstitious- 
ness of the average nurse. For a long time all went well, until 
one evening he began to cry in bed soon after he was left for the 
night. At this unusual occurrence I mounted the stairs and in- 
quired the cause of the boy's trouble. He said there were lions 
in the house, and that he did not want to stay alone as he was 
afraid they would eat him. The source of the idea had been 
that the lions had roared more loudly than usual on that partic- 
ular afternoon, and he had been much impressed, standing for 
some time quite motionless before the cage, though unterrified. 
I soon convinced the boy that the lions had to remain in their 
cages and could not get out, hence there were none in the house, 
so that there was no occasion for fear. Of course, it was first 
necessary to give him the feeling of security gained by embrac- 
ing me, and secondly to begin the conversation by talking of 
something else. In this way the state of terror was dismissed 
and the feeling of protection was induced before we returned to 
the subject of the lions. Then we made rather a joke of the 
funny roaring of the lions before we had finished, and he finally 
lay down with the solemn purpose to go to sleep and think, as 
I had suggested, of the cars and motors passing outside his open 
window. It was all a very simple substitution (13), but it was 
the prevention of what might have become a serious fear- 
psychosis (14) if injudiciously handled. 

When the fears are already formed the resources of a good 
neurologist should be invoked in order to disperse them. I give 
an illustration. 

A girl of 16 (Case 89) was referred by Doctor Litchfield, of 
Pittsburgh, November, 1913, on account of great nervousness 



670 APPENDIX 

for years. She had never been regularly to school until the fall, 
when she had been sent to boarding-school after convalescing 
from appendectomy, but had become so nervous that she had 
to return in two days. Inquiry showed that she would frequently 
wake in the night very much afraid unless she were soothed by 
some one sleeping with her, so that she could never sleep alone. 
Further inquiries showed that a servant had told terrifying stories 
to her sister as a child; the horrors this brought ran through a 
family of three children, but they passed away from all of them 
except this patient. She had been much indulged between the 
ages of 3 and 6, and had been somewhat spoiled since, owing to 
a supposed weak heart, and had always been considered a weakly 
child. Her father and an aunt had been timorous as children; 
the latter, for nine years, had not dared to be alone for a moment. 

Her fears are either of fires or burglars, and they only occur 
when in bed or asleep; she whines when dreaming and wakes 
frightened. She never screams, but clutches her companion 
desperately for reassurance. She is sure she wants to get rid 
of this trouble. She cannot remember the first occasion of fear. 
Noises, such as creaking floors, make her think there is some one 
in the house; although she knows positively there is not, she can- 
not make herself believe it. She is ashamed of the emotion and 
will go to bed alone, although terrified, if there is some one else 
up-stairs, but not unless; but will wait until her mother comes. 
She imagines a burglar might hurt her if pushed to it. 

Analysis shows that there is no definite fear of what he might 
do to her, but that the fear is of the unknown, and although it 
might help her to know it, it might be too terrible. Her agita- 
tion upon speaking of this she attributes to her shame of being 
" babyish." I explain there is no shame in what one cannot 
help, but she cannot recover until an understanding is gained 
through analyzing the situation. She is not less frightened when 
away from home, but any person in the room will tranquillize 
her fear upon wakening if she can touch her. The night fear is 
quite different from any fears in the daytime. 

After the analysis she was asked to go home and write out her 
impressions of the situation, which she did as follows: 

The earliest instance I can remember was about eight years ago 
when my nurse sat in the next room while I went to sleep. For five 



A MEDICAL SYMPOSIUM 671 

or six years afterward some one was with me when I was going to sleep. 
If I woke up in the middle of the night — which I usually did — I would 
be terrified and go into mother's bed, with her, in the next room. It 
is only within the last few months that she has been sleeping in the 
same room with me the entire night. Before that I always went to bed 
in the room next hers, but rarely remained there all night. I cannot 
ever remember having the nurse put me to bed and then leave me to 
go to sleep by myself. She was always in the next room. It made very 
little difference whether my mother, nurse, or sister were with me. I 
preferred mother, but would have any one rather than be alone. I 
was always worse in our city home than in our country home, because 
I thought there would more likely be burglars in the city than way 
off in the country. I would go to sleep more quickly in the country, 
but would always have some one with me. As long as I can remember 
I have dreaded the night. I always lie awake a long time after going 
to bed fighting with my terror of burglars. Every sound made me think 
of them, and I used to hold my ears shut so that I could not hear the 
floor creak, and try to go to sleep in that way. So when I thought of 
those long, sleepless hours I would wish there was no such thing as 
night. 

Her dread is mingled with self-contempt at her " silly baby- 
ishness." Three dreams were obtained. The first and second 
were of a burglar entering a window. The analysis showed only 
that the intruder aimed to shoot her sister, who was standing up 
behind her; a dream of fears of elevators led to no pertinent 
associations (15). 

As the dream analysis was so unfruitful I believed it best to 
proceed at once to reconditioning of the psychological reac- 
tions (16). This was attempted in the first place by studying 
the child's power of understanding of what I gave her to read 
about the psychology of fear, and by making clear to her what 
she could not understand alone. In the second place, she was 
given exercises in mental concentration, and as she became more 
proficient in these, was urged to apply them to the study of her 
own feelings of nocturnal apprehensions. The principle she was 
made to grasp was that fear, and shame of her fears, prevented 
her from facing and examining them, which was the essential 
preliminary to the understanding which would make them dis- 
appear. In ten days she returned home, not yet able to sleep 
alone, but beginning to obtain mastery. A month later her 
mother wrote me that she was entirely well, and when she awak- 



672 APPENDIX 

ened in the night would quietly turn over and go to sleep with- 
out troubling any one. She was physically and in mental health 
better than at any time in her life. 

This child has been at school now two years, and is quite 
normal. 

Concerning Shame and Anxiety. — Shame plays a large part in 
this case; but shame is merely social or moral dread, and, 
physiologically speaking, must be treated just as is fear. 

When the moral factor is very strongly present, and the 
physical agitation is decided, the condition is termed anxiety. A 
great deal has been recently written about the victims of chronic 
anxiety; but most of the writers are too narrow in their concep- 
tion in relation to the fear or shame which is its basis, and have 
often strained their explanations to fit a preconceived theory. 
In this respect the work of Doctor Boris Sidis, in this country, 
and of Doctor Pierre Janet and of Professor Dejerine, in France, 
are notable exceptions. Upon the foundation of anxiety are 
frequently developed scruples and little manias (17) or even 
tricks of manner, expression, and gesture. The grimaces which 
children make sometimes have this foundation. 

They are immediately due to a sensation of discomfort. When 
this is more purely intellectual it gives rise to a feeling of incom- 
pleteness or inadequacy to a situation. When focussed upon 
some particular idea the feeling of inadequacy may give rise to 
an obsession (18) concerning the difficulty presented. This be- 
setment is always accompanied by a certain morbid dread known 
as phobia (19). These various symptoms have the same psy- 
chological foundation, and very frequently alternate in the same 
patient. These manifestations are termed by Janet psychas- 
thenia. Again the best understanding of the situation is 
furnished by an example, although the well-developed disease is 
unusual in children, as the manifold symptoms require an intel- 
lectual bent which few children possess. 

Multiple Manias. — A boy of 14 (Case 90). He was not 
doing well at school; he would take hours to dress in the morn- 
ing, and would go away and dream by the hour. Analysis of 
the situation showed that his condition was the result of reac- 
tions caused when the child was only three and one-half years of 
age. He had been the only child, much petted and loved. When 
he was two and a half years old a little brother was born, and he 



A MEDICAL SYMPOSIUM 673 

was jealous of the newcomer, who immediately became the 
petted and loved one of the family. He was reproached by his 
parents. In consequence, he was made to feel hyperconscien- 
tious because of his bad behavior, and forthwith developed little 
" manias " as expiations which led eventually to the more com- 
plex symptoms which had developed when I saw him. Instances 
of these are not uncommon even among persons judged normal; 
thus, many persons feel that the mere touching of wood or avoid- 
ance of the number thirteen wards off misfortune. People tend 
to do these things to be rid of an uneasy feeling. Whether or 
not these are interpreted in some definite way or not depends 
on the environment. This boy, for instance, felt he was unrea- 
sonably jealous of the little brother, and that he must do some- 
thing to compensate for it — to touch wood or to put on his clothes 
slowly or in a particular way; and he had, as a result, built up 
this elaborate series of habits. He was cured in a few months. 
Malady of Scrupulosity. — The son of a United States senator 
(Case 91) was 30 years of age when seen. His condition had 
been very serious for a long time. He was cured in less than two 
years by a gradual education which freed him from extreme de- 
pendence upon oversolicitous parents. The young man would 
take two or three hours to dress in the morning, even when 
helped. He had lost all initiative, and before performing any 
act felt compelled to go through numerous trivial expiations. 
Manifestations of this kind are not uncommon. The persons 
subject to them are sometimes mistakenly called neurasthen- 
ics (20). But the condition is usually psychogenetic, and always 
arises from habits of thought and emotion which have been 
allowed to arise during childhood because the parents have not 
known of the danger of oversolicitous, excessive sympathy or 
its contrary: neglecting the child's affections until he falls back 
upon self-pity. Rigid insistence upon discipline and routine is 
a fertile source of psychasthenia. In the United States it has 
not often been severe, but in Germany many hundreds of chil- 
dren have been so psychasthenic that they have committed sui- 
cide because unable to endure the stress of existence. Over- 
insistence upon religious tenets, more especially when these have 
a basis of asceticism, has produced a great deal of this malady 
of scruples, as Janet has called it. This again is less abundant 
in the United States than in countries where the church has 



674 APPENDIX 

greater authority. Especially prone to these dangers are chil- 
dren who from any cause are kept from close companionship 
with other children, e. g., an only child, a child in a family which 
thinks itself better than its neighbors, a delicate or much-refined 
or unusual type of child who is too sensitive to the gibes and 
cruelties of youngsters, tends to lack the intimate companionship 
which would neutralize the morbid influences at home. Lastly, 
physical disorders themselves may give rise to timorousness and 
scruples which make of life a psychasthenic thing. 

Psychic Hardening. — Just as the bones and muscles become 
strong by arduous exercise in childhood and early youth, so does 
the psyche become resistant to the " slings and arrows of out- 
rageous fortune " by practice against them during childhood, 
the formative period. It is a crime against a child not to give 
him practice in self-mastery against rebuffs, snubs, slights, and 
discouragement; for if he encounters them for the first time 
when mature, the struggle against his feeling of injury will re- 
quire enormous energy, and seriously interfere with both happi- 
ness and efficiency; whereas the child soon rebounds against the 
insults without undue melancholy provided the education is 
begun very young. 

Shame of Sex. — A matter which* causes distress of mind to 
some young people, more especially girls, is shame of the bodily 
functions. The painfulness with which what they have come to 
regard as a sacred mystery meets the shocks of what to them is a 
callous, ribald world, would have been avoided had their educa- 
tion been conducted with respect to their own physiology at the 
proper time, that is to say, when they made inquiries concerning 
what they observed. Instead of that, the barbarous idea of the 
shamefulness of a normal function is inculcated, implicitly at 
least, and the consequence is a large number of what have been 
called sexual neurasthenics, who are often too ashamed even 
to consult a doctor. Hence they ask advice of advertising 
charlatans, who only add to their horror and then exploit them 
for gain. 

Shyness. — Social timorousness, which is only a kind of shame, 
finds a powerful antidote in games; for these encourage the free 
play of the inclinations and initiative in dealing with persons on 
an equal footing, so that the timid child is often surprised into 
dealing with the situation just as any one else does. Therefore 



A MEDICAL SYMPOSIUM 675 

he gains confidence in his capacity, and encouragement to try- 
something else which his diffidence has prevented hitherto. 

For the timorous child, social intercourse should be shorn as 
much as possible of conventional restrictions. Americans, es- 
pecially in the West, can scarcely realize to what a degree con- 
ventionality and artificial class distinction has interfered with 
social life and the integration of corporate activity in monarchical 
countries. 

To protect a thoughtful child from being victimized by social 
shame which he would allow to eat his heart out rather than 
divulge, a good method is to explain to him the idea of social 
solidarity, and his own place in the human cosmos: so that, 
when treated rudely or superciliously, he will understand that 
he need feel no embarrassment — for it indicates merely a lack of 
good breeding on the part of the person who so treats him. 



DEFINITIONS 

1. Germ-Plasm. The portion of the ovary which does not take part 
in the development of the body of the embryo but gives rise to the 
reproductive elements in the adult. 

2. Psychopathology. A word used to denote abnormal behavior not 
due to physical defect, but the result of impressions upon the mind. 
Peculiarities of temper, bad habits, perverted inclinations, morbid fears, 
annoying thoughts, irregularities and incapacities in movement may 
each be the result of causes purely psychological. The science of their 
causation is called psychopathology. The science of their treatment is 
called psychotherapy. 

3. Protein. The nitrogen-containing substances of living bodies as 
detected by chemical analysis. They are of different kinds and are es- 
sential for growth and the maintenance of body weight. Their chief 
dietetic representatives are eggs, lean meat, milk, and cheese. 

4. Pnrin. The substances which give rise to uric acid. 

5. That is from unmilled grain. 

6. Protoplasm. The portion of the body which is alive as dis- 
tinguished from bone, skin, and other substances manufactured by it. 

7. Mechanism. A simile borrowed from mechanics to denote the 
constituent mental processes of the complete account of any psychologi- 
cal situation. 

8. Tic. An abnormal movement not produced by mechanical or 
chemical agents, but due to an act of the will. It has the character 
of compulsion and inopportuneness to the surroundings. It is usually 



676 APPENDIX 

derived from some purposive movement the occasion for which has 
ceased. It acts as a relief to feeling of discomfort or tension. When 
the tic is frustrated by the will, much distress is caused at first. To 
cure a tic, either the discomfort upon which it depends must be dis- 
covered and removed, or else the patient must be taught to master the 
impulse to perform the abnormal movements. This is accomplished 
by disciplinary exercises in controlling those muscles which tic. This 
is facilitated by all kinds of training in self-control. 

9. Psyclwmotor. Movements inaugurated by psychological means as 
against automatic movements, and especially designed to develop the 
function of control. 

10. Psycho genetic. That which is produced by the psyche, that is 
to say, the emotions, intellect, and will as against the soma, or body, 
which comprises purely mechanical and chemical agents. 

n. Psychoneuroses. Mental disturbances not caused by bodily 
disease, and which do not lead to dementia or other mental alienation. 

12. Pavor Noctumus. This was once supposed to be a disease in 
itself, and a great deal of superstition gathered round its very alarming 
manifestations. 

13. Substitution. The process of changing one idea for another 
which dominates the mind. 

14. Psychosis. A term used in two senses. In psychology it is 
equivalent to a psychological state or episode. In medical psychological 
work it has been used to denote a condition involving insanity. 

15. Associations. Process by which episodes occurring together or 
in sequence are linked in memory. The notion of causality is a matter 
of association. Analysis of unusual juxtaposition of ideas sometimes 
reveals circumstances which have led to psychoneuroses. 

16. Conditioning. A term given to a changing of reaction to cir- 
cumstance through modifying the ideas regarding it. It is a change of 
mental attitude. Its potentialities are enormous. 

17. Mania has two senses. The best known one is that of violent 
insanity; the other meaning, used here, is of a little twist of thought, 
a slight obsession. The term monomaniac refers to this sense of the word. 

18. Obsession. A morbid idea not so fixed but that the victim ques- 
tions it, and quite realizes its morbidity. The struggle for verification 
gives rise to discontent and distress. The doubting mania is a form 
of it. 

19. Phobia. An obsessive fear not warranted by external circum- 
stances. Very common is the fear of high or wide places, the fear of 
microbes, pollution, assault, animals, the dark, of rain, in fact of any 
situation of human experience; or even a fear of the unknown. They 
are entirely curable by modern psychotherapy. 

20. Neurasthenic. A term which should be properly restricted to 



A MEDICAL SYMPOSIUM 677 

conditions of simple exhaustion or failing stamina of which the mechanism 
is physical. In this sense, it is by no means so common a condition as 
was supposed at the beginning of the century. 

Note. — The practical suggestions made by Doctor Williams, in this 
illuminating paper, for treatment and re-education are particularly 
welcome in this volume as they tally so well with the methods used in 
the author's own practical work, as exemplified at "Herbart Hall." 
— M. P. E. G. 



XX. EPILEPSY 
By Doctor D. C. Main, and Miss Sarah Bard, Welaka, Fla. 

Extent of the Epilepsies. — The epilepsies, in one or more of 
their various manifestations, claim as victims approximately one 
in three hundred of our population. 

This dreaded disease has been known for centuries, but it is 
only within recent years that any material progress has been 
made in its scientific study and treatment. Modern research 
has opened up a new vista of hope for many of the afflicted ones, 
where formerly none was given. 

If we consider only the extreme forms of chronic cases, we may 
regard them all as hopeless and unfit to remain in the family or 
under normal social conditions. 

Causes of Epilepsy. — There is no specific cause for the various 
manifestations of this condition; on the contrary, its causes are 
numerous and varied. 

Epilepsy is less distinctly congenital and less due to perverted 
development without disease than some other conditions dis- 
cussed in this book. 

Epilepsy, alcoholism, and insanity in the parents; brain in- 
juries; the infectious diseases of childhood; food poisoning; and 
the specific body diseases are among the many causes of epilepsy. 
Too much stress cannot be laid on the part adenoids play in the 
production of epileptic seizures. 

Heredity is the greatest single factor in epilepsy, sixteen out 
of every one hundred cases being directly attributable to the 
same disease in the parents. 

Treatment of Epilepsy. — The general treatment of epilepsy is 
only possible in its entirety in special institutions conducted on 
the colony or small village plan, where the outdoor life with a 



678 



APPENDIX 



regular occupation, such as gardening, poultry- raising, etc., can 
be followed. The epileptic patient should have the opportunity 
to choose the line of work on the farm most congenial to him, 
thus employing his mind and preparing him to be self-supporting 
in the future. 

The exercise thus obtained is conducive to long hours of sleep 
and good digestion, so essential in these cases. 

One of the most common mistakes parents of defectives make 
is to allow the child to run wild, abandoning all discipline, in 
the hope that the attack will come less often. They should re- 
member that the victim of epilepsy needs more than most people 
the self-control and good habits which only wise discipline in 
early life can establish. 

Dietetic Treatment. — Too much stress cannot be laid on the 
dietetic treatment. That evolved at Craig Colony is probably 
the best. The schedule is here inserted: 



Breakfast 


Dinner 


Supper 


Sunday Oatmeal 


Soup 


Bread 


Bread 


Vegetables 


Butter 


Butter 


Roast beef 


Tea 


Coffee 


Bread, butter 


Cookies 




Gelatine pudding 


Milk toast 


Monday Creamed codfish 


Soup 


Stewed prunes 


on toast 


Boiled rice 


Bread, butter 


Bread, butter 


Potatoes 


Tea 


Coffee 


Mutton 
Rice pudding 




Tuesday Oatmeal 


Meat stew 


Buttered toast 


Bread, butter 


Potatoes 


Baked apples or 


Coffee 


Vegetables 
Bread, butter 
Fruit 


apple sauce 


Wednesday Oatmeal 


Soup 


Hot corn bread 


Baked potatoes 


Roast beef 


Crackers 


Rolls, butter 


Mashed potatoes 


Cheese 


Coffee 


Vegetables 


Butter 




Tapioca pudding 


Tea 



A MEDICAL SYMPOSIUM 



679 



Thursday 



Friday 



Saturday 



Breakfast 
Oatmeal 
Bread, butter 
Coffee 



Oatmeal 
Bread, butter 
Coffee 



Oatmeal 
Rolls, butter 
Coffee 



Dinner 
Soup 
Beefsteak 
Boiled potatoes 
Vegetables 



Supper 
Apple sauce or baked 

apples 
Bread, butter 
Gingerbread 
Tea 



Soup Canned fruit 

Fresh fish (baked) Bread, butter 
Boiled potatoes Cheese 
Stewed tomatoes Tea 
Bread pudding 



Soup 

Roast beef 
Boiled potatoes 
Macaroni 
Corn-starch pud- 
ding 



Hot corn bread 

Butter 

Fruit 

Tea 



This dietary excludes an overabundance of nitrogenous foods, 
sweets, fats, and hot breads. The meat preferred is beef, and 
the only other meats ever given are mutton, fish, and chicken. 

Potatoes, beans, peas, onions, turnips, oyster-plant, beets, 
parsnip, celery, corn, tomatoes, carrots, and spinach are the 
vegetables used. 

Medical Treatment. — Space forbids many words on the medi- 
cal treatment, but if the cause be found the treatment will sug- 
gest itself. If adenoids are the existing cause, operate; if food- 
poisoning, correct the diet, etc. 

Any of the preparations containing the bromides are harmful, 
only giving temporary relief, and often doing the brain more 
permanent injury than the disease itself. 

Every departure from a normal anatomical or physiological 
condition should be corrected, so far as possible, in the hope — 
which is often realized — that it is in some way a factor in the 
production of the seizures. 

Potential Epilepsy. — The subject of potential epilepsy can 
only be lightly touched upon. 

The potentially epileptic child has the epileptic or convulsive 
tendency, and is only waiting for conditions to arise which will 
favor the appearance of the disease. If these favorable condi- 



680 APPENDIX 

tions do not arise, the epilepsy never appears. Many a potential 
epileptic has been saved from his epilepsy, beyond doubt, by the 
early correction of diet and habits, and the early removal of ade- 
noids and other surgical conditions. 

The child who is subject to night terrors, or who has had con- 
vulsions as a result of dietetic errors or during dentition, who has 
had any of the specific diseases of childhood, who has had rickets, 
severe head injuries or cerebral palsy, or who has a bad parent- 
age may be a potential epileptic, and should be watched and 
have early training begun, even though an epilepsy may never 
appear. 

Mental Condition of Epileptics. — Mentally all epileptic chil- 
dren are exceptional, some being unusually bright, others un- 
usually dull. 

Among the bright and clever ones it is not uncommon to find 
that they are allowed to outstrip their playmates, by way of 
proving that there is nothing the matter with them; but to the 
trained observer there is something pathetic in the ill-balanced 
morbidness of their cleverness. 

Some of the slow-minded ones are found to be extremely con- 
scientious, and it is well to watch and encourage these. 

Since the types vary so greatly, the proper disciplinary treat- 
ment must vary also, each child being dealt with according to his 
individual peculiarities. 

Possible Improvement. — It has come to be regarded that, no 
matter what the cause of the epilepsy, if the mental condition 
remain unimpaired, improvement and often a cure is possible. 

Patients having Grand Mai attacks are also more amenable 
to treatment than those having other types, or those in which 
the types are mixed. 

About 85 per cent of all epilepsies begin before the twentieth 
year, the essential epileptic periods being the years between the 
fifth and the eighth, and the twelfth and the seventeenth year. 

An epilepsy arising in the first period is the hardest to cure, 
recent cases being twice as likely to respond to treatment as 
chronic ones. 

About 10 per cent of all epileptics become insane. Repeated 
attacks tend to weaken the mind and to enfeeble the body. 
Some forms destroy the mind in two or three years, while others 
persist through life with little or no effect on the mind. 



A MEDICAL SYMPOSIUM 6S1 

Epileptics are especially prone to tuberculosis, organic heart- 
diseases, and many sustain fatal injuries during attacks. 



XXL SEXUAL HYGIENE 

By Doctor Arthur W. Weysse, Boston, Mass. 

The Role of the Sexual Instinct. — What can be done for the 
exceptional child in the matter of sexual hygiene? The role 
played by the sexual instinct in the normal adolescent is a very 
varying one. In a few individuals the onset and development of 
the sexual passion are gradual and uneventful, and, while giving 
rise to new sensations and emotions, they cause no disturbance 
of the metabolic equilibrium. Such cases are rare, but they do 
occur. At the other extreme we find individuals who must be 
regarded as normal in whom the sexual passion occupies a major 
place in the personal economy It obtrudes itself upon their 
thoughts, it affects all their bodily activities as well. Between 
these two extremes we find all possible gradations. The majority 
of adolescents, then, are in a state of more or less unstable equilib- 
rium in the metabolic processes — a lack of stability that is not 
due alone to the rapid growth of the child, for it is not present 
(to the same degree at least) in the normal child before puberty. 
The exceptional child is in a more unstable equilibrium physio- 
logically than the normal child; hence the need for special atten- 
tion to sexual hygiene in his case. 

Masturbation. — Any one who has made an intensive study of 
sexual matters knows that the practice of masturbation is ex- 
tremely common in children of both sexes during the adolescent 
period, so that some writers have been led to consider that it 
is normal in civilized society, that it is no more harmful than the 
same amount of normal sexual intercourse would be; and the 
percentage of children addicted to the practice has been placed in 
the nineties. However that may be, the fact remains that most 
children indulge more frequently than they would indulge in 
normal intercourse, as we know from studies of uncivilized tribes 
where no restraint is placed on intercourse. Further, the energy 
thus expended would much better be used for the other activities 
of the body, and the weakening of the will-power through the 
repetition of the act is a matter of no small moment. If these 



682 APPENDIX 

facts are true for the normal child, they are even more significant 
for the exceptional child. I believe that in the majority of cases 
masturbation is not a result of viciousness, but rather of excessive 
stimulation of the reproductive system through a variety of 
causes for which the child is not personally responsible. 

Causes of Masturbation. — The diet of the child is often at 
fault. Children at puberty do not require the stimulus of 
caffein, nor is it desirable, yet many of them get it. Excessive 
quantities of spices, pickles, and sweets result in abnormal metab- 
olism, and a consequent derangement of more than one function 
of the body. If the sexual system becomes hypersensitive under 
these conditions, it is the fault of those who have charge of the 
child. The genital organs themselves should receive expert 
attention. In some cases the cause lies in an adherent or in a 
redundant prepuce, in others in phimosis, in others in an exces- 
sive secretion of smegma which the boy does not know that he 
should remove. There is a great variation in the amount of this 
secretion in boys; in some it is so great that it should be removed 
by washing at least once every twenty-four hours. Most boys 
receive no instruction whatever in this matter. Some boys have 
an unsuspected congenital stricture of the urethra that may lead 
to enuresis and involuntary manipulation of the genitals. 
Some have a stone in the bladder; I remember seeing a vesical 
calculus removed from a boy of 10 in a London hospital a few 
years ago. 

In girls there are very frequently unsuspected adhesions about 
the clitoris that lead to masturbation. Such cases have been 
reported in medical literature within the past years; they are 
readily relieved by circumcision. 1 Vulvovaginitis may cause 
masturbation in little girls; it is a much commoner disorder than 
many suspect, and its etiology is often obscure. Sometimes it is 
due to the gonococcus, but very frequently to other organisms. 
Careful medical examinations of the genito-urinary apparatus 
should be the rule in the case of exceptional children, and for 

1 Not always, that is to say, only when there are no other complications of a 
physiological or psychological character. The author has had a little girl of 
10 (Case 92) under observation who was badly affected. Adhesions to the 
clitoris were removed, and vulvovaginal treatment established. There seemed 
to be no other physical or local cause, but the masturbation was not checked 
by these measures. — M. P. E. G. 



A MEDICAL SYMPOSIUM 683 

that matter is highly desirable in the case of normal children 
as well. 

Sexual Education. — Concerning the normal physiology of the 
genital organs at puberty — the appearance of the menses in girls, 
and of nocturnal emissions in boys — I believe that each child 
should so far as possible receive individual instruction. This 
information may be imparted by the parent if he or she has the 
proper personality. If not, it would much better come from a 
physician. In my opinion, class instruction is much less de- 
sirable. 

Sexual Abnormality as a Cause of Exceptional Development. 
— Some children are undoubtedly exceptional through abnormal 
development of the sexual organs, which causes either retarda- 
tion or precocity. Exact knowledge of the cause of these condi- 
tions is still lacking, but recent experiments on animals and the 
clinical reports of several years show us that the endocrinal or 
ductless glands have a very pronounced influence on sexual de- 
velopment. The two glands that seem to be most important 
in this respect are the pituitary and the pineal, but we know 
now that the endocrinal glands do not act entirely independently. 
A recent case reported in medical literature (Case 93) is illus- 
trative of this: Shortly before his death, a boy of 5 years and 10 
months was 42 inches tall, 24 inches around his chest, and had 
genitals the size of those of a man. His death and his excessive 
bodily and sexual development were due to a large tumor of the 
cortex of an adrenal gland, while the pineal and the pituitary 
glands were normal. Lack of secretion of the pituitary body 
results among other things in retarded sexual development — the 
persistence of infantilism so far as the sexual organs and instinct 
are concerned. It has been thought that the pineal gland, which 
attains its maximum development between 7 and 13 years of age, 
and then degenerates, might exercise a retarding influence on 
the development of the sexual organs, and that precocity might 
result from a lack of pineal secretion. Recent experiments on 
young animals, however, show that when fed with this gland 
they developed both somatically and sexually more rapidly than 
normal animals of the same species. Extract of the pituitary 
body has been given in cases of infantilism with good effect, and 
we shall doubtless soon be able to treat both precocious and re- 
tarded sexual development more effectively. 



684 APPENDIX 

XXII. SOME SEXUAL ABNORMALITIES 

By Doctor W. F. Blake-Burke, Plainfield, N. J. 

Atypical Children and Sexual Problems. — In studying the 
group of exceptional children which Doctor Groszmann has 
designated as atypical, we are confronted with many cases in 
which the sexual life is perverted or at least gravely endangered. 
This is more particularly true of Class (a) of this group, "Neu- 
rotic and Neurasthenic Children." As a matter of fact, a certain 
school of psychiaters maintains that neurotic and psychopathic 
tension is invariably and intimately associated with, or even 
caused by, difficulties and abnormalities in the early sex life of 
children of both sexes. 

The second class of atypical children, " Children of Pathologi- 
cally Retarded Development," furnishes its quota of sexual per- 
versions and inversions (homosexual manifestations). For it is 
this retardation in the development of physiologic function, with 
its bodily counterpart of infantile anatomical conditions in the 
reproductive organs, which is more or less directly responsible 
for sexual abnormalities. It would be perfectly correct to say 
that much of neuropathic and psychic tension is produced through 
this pathologic retardation of the physiologic growth rate in the 
sexual sphere when it stands in contrast with overstimulation 
and rapid growth in other directions. 

Infantile Conditions. — The fact obtrudes itself upon our con- 
sciousness that the characteristic manifestations of the infantile 
sexual life persist in the adolescent of these types as inversions 
and perversions. 

These infantile manifestations become exaggerated in the 
preadolescent or latent period, and labor against the influence 
of education, thus producing in the adolescent a generally back- 
ward mental condition. The sexual life in these children seems 
to eat up all their energy, to pervert all the strength they need 
for making normal intellectual progress. 

In other cases we find in the adolescent a seemingly normal 
intellectual development which, however, when put to the test 
of the ordinary struggle for existence, fails owing to weakened 
stamina and exhaustion of reserve force. 



A MEDICAL SYMPOSIUM 685 

Timely Training. — My own practical observations strongly 
uphold Doctor Groszmann's contention that it is in the second 
or latent (prepubertal) period that special educational training 
will have the best chance of success. It is, therefore, absolutely 
necessary to watch out for evidences of abnormal sexual manifes- 
tations in this period — although it should be admitted that the 
" normal " for this period has still to be definitely determined. 
Nevertheless, any pronounced interest in sexual matters and 
symptoms of self-abuse or sexual aberration will have to be con- 
sidered as danger-signals. There is little hope for cases of this 
kind without timely special educational training. For it is the 
instinct of sex with which every child is born which furnishes 
energies of tremendous power which are needed in the normal life 
evolution of the child, but which are deviated or sublimated in 
the latent period. Educational methods following the cultural 
development of the race will use them as barriers against which 
the storm and stress of adolescent days will battle in vain. Out 
of the period of mere sex-instinct, represented in the develop- 
ment of the race by the period of sex-worship and sex-fetichism, 
which reverberates in many of the early sex mannerisms of chil- 
dren, must rise the consciousness of higher entities in human re- 
production. 

The infantile form of the sex-instinct is intimately associated 
with other bodily functions, especially those of secretions which 
are located in or near the sex-organs. Allow them to continue 
unchanged through the latent period, and they will recrudesce 
as inversions and perversions in the adolescent. Ignorance of 
the infantile sexual life; misappreciation of the grave significance 
of abnormal sexual manifestations in the latent period, be it from 
prudery or ignorance; repression of sexual consciousness on the 
part of the child himself, from terror, shame, or ignorance, are at 
the root of abnormal developments in the later sex life. 

The result is that mental development is retarded; even the 
ordinary somatic changes of adolescence are often absent. The 
natural purpose of sex development is obscured, the individual 
lingers in the preparatory stage and is led into harmful prac- 
tices; and in the cases of more profound infantilism in this 
province we find even anatomical vestiges of hermaphroditism 
pointing back to the beginning of the formation of the sexual 
organs during intrauterine life. 



686 APPENDIX 

Constipation. — Constipation in children of the type to which 
I have alluded is very often obstinate and of special significance. 
In many cases it yields to proper methods of treatment: diet, 
exercise, mental discipline, and suggestion, etc. Several cases 
have come to the writer's attention in which these methods 
seemed unavailing for quite some time. Two cases are of especial 
interest; in both, there seemed to be intentional retention of 
fecal matter for purposes of sexual stimulation. Both had suf- 
fered from constipation from early childhood, so that it must be 
assumed to have been a causal element in the production of ab- 
normal sexual feelings. After this had been recognized by the 
boys in question, it was purposely used for the gratification of 
these feelings which had been found pleasurable. 

Other Irritations. — There are, of course, other irritations lead- 
ing to similar results. Abnormalities in the urinary tract and 
hyperacidity of the urine may irritate the sexual parts and cause 
sexual reflexes and masturbation. In boys, an ill-fitting saddle 
of a bicycle or horse may produce an irritation. In girls, riding 
a bicycle, or riding a horse astride, or even working a sewing- 
machine, has led to violent masturbation. The sedentary habits 
of the ordinary school child, especially during the preadolescent 
period, have played sad havoc with the awakening instincts. 
The child who wriggles in his seat, or seems to lose himself in 
self-absorption, with a fixed stare, needs a teacher's immediate 
attention. 

It is thus seen that too much attention to the fundamental 
bodily functions of preadolescents, even of young children, can- 
not be paid by parents and family physicians; and that in the 
treatment of sexual aberrations, observation must be directed 
to these contributing factors. What has not been accomplished 
during the latent period in a child's development will present 
particular difficulties of management. We are dealing not only 
with psychopathic or neuropathic symptoms pure and simple, 
but with a perpetuation and recrudescence of infantile symptoms 
of sex-consciousness. While it is true that there is a distinct 
medical aspect to these cases, the matter of re-education is para- 
mount, and this educational process will be most successful when 
begun before or during the latent period. An early diagnosis is 
essential. 



A MEDICAL SYMPOSIUM 687 

XXIII. TREATMENT OF JUVENILE DELINQUENTS 

By John Adams Colliver, A.B., M.D., Los Angeles, Cal. 

A Medico-Socio-Psychological Problem. — The treatment of 
juvenile delinquents is not purely a medical subject, of course; 
but a medico-socio-psychological problem. The real delinquent, 
the repeater, has formed a bad and antisocial habit, and his 
case is, therefore, chronic. In order to bring about corrective 
results it is necessary to consider the subject from an etiological, 
pathological (perversion), curative, and prophylactic point of 
view. 

Etiology. — The analysis of a few thousand cases examined by 
me shows that nearly 95 per cent are from broken homes; that 
is, where one or both parents are dead, or morally or mentally 
unable to discipline their children or themselves. Thus, the 
child has little or no home training of any value. This condition 
is always associated with bad environment, idleness, rarely with 
overwork, and is productive of vice and perverted habits which 
affect the child by the force of bad examples. On the other hand, 
the 5 per cent from good homes have been overindulged. It is 
useless to try remedies if the above-mentioned contributory fac- 
tors are overlooked. 

Pathology. Perversion. — Under this heading we consider two 
kinds of cases: those which cannot be helped, and those which 
can. In the first class we find about 18 per cent who are men- 
tally defective. These, of course, should be graded and schooled 
accordingly. Another species of this same class is afflicted with 
so-called manias. I have seen numerous cases where the child 
was apparently normal, but possessing a peculiar mania for steal- 
ing certain things, as money, tools, jewelry, women's clothing, 1 
bicycles, and the like. These were stolen solely for the irresisti- 
ble pleasure of doing it. 

I do not believe there is a characteristic criminal type among 
children; nor that a blow on the head will produce criminality, 
notwithstanding the fact that many parents believed that the 
badness in their children dated from such a blow. Scarcely a 
week passed for several years in which some did not appear in 
court with such pleadings. I have never seen a case of delin- 

1 Here we may be dealing with a perverted sexual instinct. — M. P. E. G. 



688 APPENDIX 

quency due to such head or brain injury. Such bumps or in- 
juries do not tend toward criminality any more than any other 
local irritation. It must be borne in mind that parents are 
usually prone to excuse their child, and the blow is simply a 
coincident in the boy's life. It has been found that a percentage 
of these boys were mentally defective. 

Under this same heading let us consider drug and cigarette 
habits and sexual perversions. It is impossible to effect a cure 
while these habits continue. They are all accompanied by lying. 
I have seen a number of cases where boys had committed crimes, 
and the only accountable reason was one or all of these habits. 
On the other hand I have seen a change in the moral character 
with the cessation of the vicious habit. We have used the silver- 
nitrate cure for cigarettes, with some good effects. 

Irritability as an Initial Symptom. — Irritability is an initial 
symptom of juvenile delinquency. 1 There is a physical basis for 
this in a large percentage of the boys I have examined. Our 
records show that over 90 per cent begin their career by irrita- 
bility at home. This percentage would probably be higher if 
better statistics were available. It has been our endeavor to 
discover, if possible, the basis for the irritability, and remove the 
same. The years before puberty represent the period when most 
good can be expected from this treatment. The nervous system 
is then still undeveloped and unstable, and inhibition incom- 
pletely developed. The irritations from local causes have ap- 
parently a marked deleterious effect upon the faculty of inhibition 
and upon the exercise of the will-power. Their removal is fol- 
lowed by moral improvement in about 16 per cent of the cases. 2 

Local Causes of Irritation. — Such defects as decayed, aching, 
or impacted teeth; enlarged or diseased tonsils and adenoids; 

1 "The Physical Basis for Irritability in Boys — the Beginning of Juvenile 
Delinquency." Address (by Doctor J. A. C), illustrated with stereopticon, be- 
fore the Riverside County Medical Society, City School Board, Teachers and 
Probation Officers, Riverside, Cal., April, ion. This paper has been published 
in the Manual of the Juvenile Court of Los Angeles, 191 2. Also reprinted by 
the New York Probation Commission, March, 1013, and by the National Proba- 
tion Commission, September, 1913. Reprinted in the Journal of Sociologic 
Medicine, December, 1915. 

5 C/. my paper : "Does the Correction of Physical Defects of Juvenile Crim- 
inals Improve Their Moral Conduct?" Read before the Southern California 
Medical Society, December, 1909; reprinted from the Southern California 
Practitioner, January, 19 10. 



A MEDICAL SYMPOSIUM 689 

defective hearing and sight ; disturbances of the intestinal tract, 
whether due to worms, undigested material, or indigestion; and, 
most important of all, irritations and defects of the genito- 
urinary system. These, together with poor nutrition, toxic, in- 
fectious, and other obscure local or constitutional causes, tend to 
block, or interfere with, the normal impulses or orders from the 
brain. 

Some of these points were emphasized and illustrated in an- 
other paper of mine. 1 There it was shown that there were 10 
to 15 per cent more cases of defective teeth among juvenile de- 
linquents than among normal children of the same age. We 
found that correction of decayed or aching and impacted teeth 
produced a change in the disposition of the child. I believe also 
that imperfect teeth, or lack of teeth, contribute indirectly to 
delinquency. For lack of proper mastication is followed by in- 
testinal indigestion, toxaemia, and poor nutrition. Correction 
of these defects eliminates this vicious train and tends to im- 
prove metabolism. I have seen numerous boys change in dis- 
position entirely when their metabolism was improved. It is 
interesting to note in this connection that my data showed that 
the nourishment was below normal in 52 per cent of the boys 
with one or more bad teeth, whereas only 10 per cent were poorly 
nourished in those with good teeth. It is also instructive to 
note that of the 10 per cent poorly nourished with good teeth 
over 65 per cent were cigarette-smokers, and had nervous dis- 
orders. Nutrition must be built up to improve inhibition or 
will-power. 

There is no doubt that the removal of diseased tonsils and 
adenoids is followed by a physical and mental improvement. 
We find also that a moral improvement appears in about the 
same proportion as the mental. This may be due to three things: 

First: As in the correction of any other defect, the removal 
of this local irritation eliminates the source of numerous im- 
pulses to the brain which have been continually interfering with 
the normal stimuli. 

Second: Practically all these cases improved physically, and 
proportionately improved in inhibition and will-power. 

1 "Does the Abnormal Condition of the Teeth Contribute to Juvenile Delin- 
quency?" Given before the Los Angeles County Dental Society. Published 
in Pacific Dental Gazette, 1910. 



690 APPENDIX 

Third: Many a child has the reputation of being incorrigible 
simply because of defective hearing. This incorrigibility is 
preceded by irritability, and followed by bad associations, vicious 
habits, and a criminal life. By removal of tonsils and adenoids 
the hearing is often restored, and the child is saved from the 
degraded future. 

Eye defects have similar results, and properly fitted glasses 
have changed the moral character of many boys appearing in 
court. 

In all cases of incorrigibility and delinquency it may be neces- 
sary to make repeated thorough examinations before a contributing, 
local cause can be determined upon. Some of the most obscure 
cases, I believe, are toxic or infectious in origin, intestinal, or so- 
called rheumatic, or possibly specific. I have seen numerous 
cases in which the child cleared up in disposition after irritating 
masses like worms, undigested material, etc., were removed from 
the intestinal tract; in a few cases, where the rheumatic or syphi- 
litic remedies were administered. 

Other Curative Measures. — Sometimes it is well to break in 
some manner the continuity and periodicity of the criminal 
offenses, and were it merely by temporary change of environment 
and occupation, or by some other temporary method. Even the 
stay in a hospital, or the treatment of some ailment may serve 
the purpose of interrupting the criminal trend or habit. Time 
is thereby given for readjustment. 

An illustrating series of observations was made on thirty-two 
cases of so-called hopelessly "bad" boys, who were submitted 
to a needed operation. In each case it was a circumcision. The 
beneficial effect was due both, I think, to the operation itself 
which removed a local irritation, and to the break in the routine 
of their lives. Each of the boys had appeared in court on an 
average of six times, once every three months. After the opera- 
tion, the interval was increased to once in eighteen months, 
although they were living in practically the same environment. 
Many of the boys who were bullies and leaders of gangs tamed 
down and reformed; others, who had been " incorrigible " and 
persistent truants changed in character entirely. A composite 
curve of the thirty-two boys is shown in the accompanying 
diagram. 

In this group we have what would ordinarily be called bad 



A MEDICAL SYMPOSIUM 



691 



5 
































u 
































g 
































g 
































"!" 
































s 
































B 
































n 






























































































R 
































V. 
































S 
































s 
































a 






) 






























/ 


























pj 
































R 
































R 
































p 
































£ 
































- 








c 
























i 
































i 
































s 




























2 
































s 
































= 
































r 












s 








{ 
























p 










s 






















■ 






























t^ 






























* 




























.,-, 
































- 










- 






















m 


























M 








\ 
























- 










<« 


> 






















00 





8 

o 


> 

| 


18 


§ 



X 
§ 

& 




I 

a 
■ 

1 


"3 


'Z 

E 

o 


■ 

B 


a 


\ 


-_■ 


•o 



a >j 



o v 
h 

on i-i 

^£ 

•2.9 



ad 



O J3- 






$< 






£-3 

:sfc 

•c-St 

CD O 

V u u 
* rt O 

D. i^ m 
SJ S <3 

if" 

U 3) M 

o 

a o a 

H 



692 APPENDIX 

boys, who have been tried in every way and were turned over as 
hopeless. Some had appeared in court for as many as ten 
offenses. Since operation, some of the boys in this group have 
not committed an offense or appeared in court in five years. A 
record of their conduct at home and at school, which appears in 
the weekly, biweekly, or monthly reports in the probation office, 
showed a marked improvement in their morals. 

Psychological. — Habits, good or bad, when long continued, 
become part of the body, and are normal physiological reflexes. 
The physiology of the boy remains the same — passive, ready to 
be acted upon — while his social environment is continually chang- 
ing. What you could do with impunity when you were a boy 
is now a trespass or a misdemeanor. Thus, new habits must be 
formed in adaptation to the ever-changing social environment, 
and to the demands confronting the individual in his ascent 
during the periods of growth. As a curative measure, new habits 
must be developed so as to supplant the old, or natural, or bad 
ones. Most important is the demand to give the boy proper 
psychological employment, that is, employment which has his best 
endeavor and attention. The value of this demand cannot be 
overestimated. Practically all juvenile courts are now beginning 
to recognize the importance of this step. If such employment 
is impossible, then find employment which is furthest from his 
greatest temptation. The boy should be forced to work at some 
highly co-ordinated and complicated employment which will 
completely occupy his mind, and he should do this daily to the 
point of fatigue. This would establish new habits. Hypnotism 
and suggestion have been used to some extent, but never with 
any degree of success. 

The conclusions in the above statement are based upon ten 
years of experience in the Juvenile Court of Los Angeles County, 
California, presided over by Judge Curtis D. Wilbur. 



XXIV. INHERENT IMMORALITY 

By Doctor Ross Moore, Los Angeles, Cal. 

Heredity vs. Free Will. — Belief in free will is the central fact 
in the system of justice and law of the past and, to a great extent, 
of the present. So-called "justice" has remembered the biblical 



A MEDICAL SYMPOSIUM 693 

suggestion that "whatever a man soweth that shall he also reap," 
and has wilfully or thoughtlessly forgotten that other statement 
that "the sins of the fathers shall be visited upon the children." 
Hence the tendency of all of us has been to hustle the one who 
transgresses our rights or comfort. This has made us complacent 
in the past to allow the courts to handle all persons convicted of 
breaches of the peace as if they were entirely responsible. Anom- 
alies of character often escape the notice of even the most expert 
character readers until some overt act calls attention to them. 
The line of distinction between the person who is morally re- 
sponsible for his acts and him who is not is often a very difficult 
one to draw. Society, not liking to be troubled with unpleas- 
ant things, says in effect: "Take them all away. Maybe some 
of them should not be punished, but we cannot take time to de- 
cide which is which." 

Types of Character. — This contribution to the Medical Sym- 
posium is an effort to clarify certain types of character. These 
types which we are to study are denied by some very good 
psychologists and psychiatrists who believe that judgment gov- 
erns the acts of all persons except those who are afflicted with 
definite psychoses. Society largely believes this way. 

Other psychiatrists believe that the majority of asocial and 
antisocial acts is the result of a definite disorder of brain function 
for which the doer should not be punished but segregated. 

Between these two extremes lies a fertile field for work. In 
this field, and rather nearer to the side of normality than in- 
sanity, are to be found the types of character about to be studied. 

In developing them, the ideas of Tanzi, the Italian psychia- 
trist, will be closely followed, because they are clear and con- 
vincing. Quotations, unless otherwise acknowledged, will be 
taken largely from the chapter on " Constitutional Immorality" 
in his book " Mental Diseases." 

The Inherent Immoral. — The "constitutional immoral," or, 
as I have chosen to call him, the " inherent immoral," is a person 
who lacks something out of his character. That something is 
large enough to mark him as being below or away from the aver- 
age man in character. It may show itself day by day, and cause 
its bearer to be labelled "queer," or it may only show under 
especial provocation. 

Tanzi's translator hit upon the word "altruism" as a name 



694 APPENDIX 

for that something which is lacking in these persons. It is ex- 
actly a lack of care for others which is the keystone of these para- 
normal characters. 

Varieties and Forms of Non-altruism. — There are many varie- 
ties and forms of this non-altruism. For instance, there is the 
hair-brained, happy-go-lucky fellow who pursues his pleasures 
and excitements to his own social and financial undoing. At 
the other extreme is the quiet, forceful, and brainy person who, 
needing ten dollars for a summer's holiday, goes out and beats a 
friend to death, robbing him of the money. 

Society never puts the former into an asylum or other insti- 
tution for the mentally afflicted because he is a good fellow — 
"foolish but a good sport." 

The latter is often hanged by society because the monstrous- 
ness of his offense raises against him a furious mob resentment, 
which listens neither to reason nor to justice. 

During the school years, the former type is a problem much 
more internal than external — more personal than social. The 
latter group, on the other hand, lies within a good part of the 
children who cause the real social problems of school life. 

Anomaly of Character. — I have given the name "inherent 
immorals" to these two groups of pathological personalities. 
Inherent immorality is neither more nor less than an anomaly of 
character. Hallucinations, illusions, and delusions, are not found 
in it. Practically all those symptoms that are relied upon to 
make the diagnosis of insanity are absent. To the occasional 
observer these persons do not excite interest, or even a second 
thought, because they appear as normal or average. The flaw 
lies in a suppression or congenital absence of a moral sense. 

When is the perpetrator of a crime a criminal, and when is he 
immoral or insane? A criminal should be punished. An insane 
person should be treated. An immoral should be permanently 
segregated or so placed as to remove him as a social danger. 
He should be legislated for and cared for on the basis of his 
irresponsibility the same as the imbecile. But he is not an 
imbecile. 

Two Distinct Types. — There are two distinct types of the in- 
herent immorals — the "impulsive immoral" and the "calculat- 
ing immoral." In addition to these there is a mixed type which, 
of course, partakes of the characteristics of both. 



A MEDICAL SYMPOSIUM 695 

Moral insanity in the adult is only the persistence of immoral 
tendencies of childhood. It is easier to sketch the adult immoral 
first, and then go back to study his youthful appearance. 

Type First: the Immoral from Impulsiveness. — This type is 
immoral from impulsiveness, or from excess of egotistic desires 
of restlessness, of aggressiveness, or of individualism. 

There is a physiological, or rather a physiopsychological basis 
for the acts of the impulsive immoral. This consists in a certain 
instability of character. A sort of weakness of inhibition, as 
for instance a tendency for gambling. Such a weakness is just 
as real in the realm of the intellect as susceptibility to certain 
articles of food such as strawberries is in the physical realm. It 
manifests itself in a constant thoughtlessness and carelessness 
toward consequences which is the despair of friends and relatives. 
Such a person will gayly sacrifice much future good for the sake 
of a vivid present indulgence. All efforts to reason with him will 
be found unavailing. 

When such a pathological personality comes into conflict with 
custom or the law, there ensues a period of genuine surprise in 
the first instance. Surprise, because he is unable to see wherein 
he is wrong. As these conflicts recur, surprise is replaced by 
irritation and then anger. And lastly anger breeds a desire for 
"getting even with a society which tries to down a man who is 
trying to live properly." 

This whole mental process is the result of the actual mental 
inability of the patient to understand his own handicap and to 
adjust himself to his sphere in life. 

This sad human wreck is the result of the inability of society 
to understand such mental handicaps. 

" In childhood immorality of the unthinking type displays 
itself in precocity of the sexual instincts, arrogance, overbearing 
conduct, lying, scheming, disobedience, running away from school 
and home, vagabondage, thirst for adventure, etc. These ten- 
dencies become accentuated about the twentieth year, and lead 
to desertion, sexual offenses, quarrelling, swindling, and foolish 
changes of residence, occupations, and friendships. Thus, out 
of immorality there is gradually developed criminality, in either 
generic or specific form." 

The key phrase to describe these unfortunates, young and old, 
is: impulsive thoughtlessness with carelessness of consequences. 



696 APPENDIX 

Type Second: the Immoral from Deficiency of Sympathy. — 
This type lacks sympathy for others, and therefore also al- 
truism, sentimental reserve of solidarity, compassion, and regard 
for public opinion (Tanzi's wording). 

I have called this type the "sluggish immoral." Not that he 
is really or necessarily sluggish in either physique or mentality. 
Possibly I should call him the "deliberate immoral." He lacks 
sympathy wholly. He has no thought for others except when his 
cold and selfish reason tells him that by helping others he will 
further his own ends. If he is polished and courteous it is for 
good and selfish reasons. His lack of moral sense leads him into 
no such headlong dashes as fill the life of the impulsive immoral. 
His decisions are planned with no qualms of conscience because 
that phase of conscience is totally undeveloped in him. 

As such a personality as this grows from childhood to adult 
life there is first a period of surprise at the tears and kindnesses 
of others around him. He cannot understand motives which 
have any other origin than selfishness. There is a gradual change 
until he develops an exaltation of his own ego, because of his 
growing conviction that his own callousness is superior to the 
altruism of his associates. Having arrived at this conclusion, 
he is ready for anything his fancy dictates, because he cannot 
sense the view-point of all the rest of the world. He is morally 
imbecile. Nothing has atrophied his mind, because there was 
nothing to atrophy. He lacked the moral sense from birth. 

No one word will describe the second group, but the word cal- 
culating comes nearest to it. He is calm, frigid, slow, reflective, 
without sympathy. 

The treatment of the two groups differs radically. The key- 
note for the first group is sympathetic understanding. That for 
the second is permanent pitying care. 

Diagnostic Elements. — At first glance it may seem that the 
first group will be hard to separate from the harum-scarum active 
youngster who is entirely normal. This is not so. There is a 
vast difference between the peevishness which accompanies 
healthful weariness after hard play in the normal child and the 
restlessness of the impulsive immoral. It is the difference be- 
tween normality and abnormality. It is as indescribable as the 
differences between many things in our experience which we are 
able to sense clearly but cannot define in words. The impulsive- 



A MEDICAL SYMPOSIUM 697 

ness is of a kind which irritates others. A driving, impulsive, 
normal youth is urged on and applauded while the impulsive 
immoral finds himself thwarted by the immobility or active hos- 
tility of his associates. 

Such personalities can be recognized in childhood. They are 
worthy of the best efforts. Their very impulsiveness can be 
turned into right channels in a good percent of the cases, and when 
so turned will often provide a force capable of more than average 
work along chosen lines. 

Sustained effort will be necessary, in order to find just what 
irritants in daily life are keen enough to allow impulse to domi- 
nate reason. 

The recognition and treatment of the second class will usually 
have to wait until some overt act is committed. This is because 
of the early development of the ability to simulate contrition, to 
cover up faults, and to smooth their own paths by smoothing 
the paths of others. There is little hope for that which is called 
"reformation" in these persons. It would have to be recreation 
rather than reformation, because it would be the replacement of 
a thing which has never existed. Their proper treatment, there- 
fore, resolves itself into the instituting of such measures as will 
protect society from their actions, and at the same time give the 
unfortunates all the freedom possible. 

The decisive points indicating the diagnosis of moral insanity, 
according to Krafft-Ebing, are: 

(i) Insanity, drunkenness, or epilepsy in the parents. 

(2) The existence of anatomical and functional signs of de- 
generacy, with special consideration of the conditions of the 
sexual life as the most important foundation of the development 
of the moral sense. 

(3) The existence of signs of an abnormal state of the vaso- 
motor functions and motor functions, as in tolerance of alcohol, 
epileptoid symptoms, etc. 

Further diagnostic light is thrown on the moral defect by the 
demonstration of intellectual weakness; abnormal emotional 
irritability; defective reproduction of ideas; impulsive, perver- 
sive feelings depending upon natural impulses and instincts; 
and finally the periodic character of the activity so frequently 
observed. This applies equally well to moral imbecility. 

It must be developed from the history of the individual 



698 APPENDIX 

whether his moral obliquity began so early as to rule out the in- 
fluence of bad example. It is also necessary to determine whether 
the conditions under which he has spent his earlier life have 
been favorable or unfavorable, whether he has had the benefit 
of broadening education. If under good conditions and in spite 
of proper education the patient's history indicates absolute in- 
corrigibility, then the diagnosis of moral imbecility may be 
tentatively made. If observation over a period of time shows 
that character is becoming less stable, then the diagnosis may be 
made permanent. 

Since the diagnostic points for these inherent immorals are so 
intangible and elusive it is well to characterize each type in gen- 
eral phraseology. The congenital impulsive immoral is charac- 
terized by impulsive thoughtlessness with carelessness of conse- 
quences. The congenital calculating immoral is calm, frigid, 
slow, reflective, without sympathy. 

Treatment. — Little more is to be said about treatment be- 
cause the locating of a given patient in one or the other class 
carries with it the general indications for future handling. The 
first group can be fitted into the proper place in life if their handi- 
caps are discovered and allowed for. The second group will 
always require supervision because they lack something which 
is entirely necessary for life in a free community. Most of them 
ultimately reach some public institution — penal, corrective, or 
charitable. Most of them get to these institutions only after 
long years of misunderstanding, or after the commission of acts 
of criminal nature for which they are not morally responsible. 
"If alienists would be firm and unanimous in declaring that 
congenital immorality is an anomaly, and not a disease, legis- 
lators and magistrates would also be more precise and unani- 
mous in assigning to the immoral by nature a treatment that 
would assure society, and still be in accord with justice and 
prudence." 

XXV. THE PROMISE OF RESEARCH IN THE 

ANATOMY OF FEEBLE-MINDEDNESS 

By E. E. Southard, M.D., Boston, Mass 

The Anatomy and Pathology of Feeble-Mindedness. — Doctor 
Groszmann has asked me to state in a few words the general 



A MEDICAL SYMPOSIUM 699 

situation as to feeble-mindedness from the point of view of the 
anatomist and pathologist. My own researches are by no means 
complete, and in point of fact what Doctor Walter E. Fernald 
and I have planned will take five years in the execution. The 
work of but two years is now available. Nothing, however, has 
interested me personally so much in my varied work in psychiatry 
as this very problem of feeble-mindedness. It is not only from 
the standpoint of the social importance of the problem of taking 
care of the feeble-minded properly. It is not merely a question 
of our interest in saving society from the evils which attend the 
community life of certain types of feeble-minded of high grade, 
namely, the subnormal 1 and moron cases; and in the other direc- 
tion, it is not merely a satisfaction of scientific curiosity if we 
attempt to study the brains of the feeble-minded with all the 
means now at our command. It is true that the anatomist has 
much to learn from the brains of the feeble-minded which will 
be of value to the science of brain anatomy itself, and it is true 
that a study of the conditions of feeble-mindedness in the com- 
munity will throw light upon a great number of economic and 
political problems. 

What has struck me of late, however, is that there is an in- 
terest attaching to feeble-mindedness which transcends the ana- 
lytic interest of the anatomist or pathologist, and transcends alike 
the interest of the social statistician. Between the medical an- 
alysts, on the one hand, and the social statistician, on the other, 
it has become increasingly clear in modern time that the indi- 
vidual as an individual gets dropped out from consideration. 
Now, studies in feeble-mindedness above all insist upon the indi- 
viduality of the case in hand. Not even the epileptics or the 
insane require so much adherence to the point of view of indi- 
vidualization since, after all, epileptics fall into major groups, and 
it is profitable to study the insane in a daily increasing number 
of forms and subforms of disease. The feeble-minded, however, 
seem all to differ from each other, and at any rate to provide 
a vast number of particular educational problems. 

Individual Problems. — The study of feeble-mindedness is a 
study of individuality. I believe it will be found to be one of 
the most profitable forms of individual study that the world is 

1 It will be seen that Doctor Southard does not use this term in the manner 
employed by the author of this book. — M. P. E. G. 



700 APPENDIX 

likely to see. I believe this will be found to be the opinion, if 
not of Pinel and Itard, then certainly of the great leader in this 
field, namely, Seguin. Whether the current of interest flows 
from Seguin to work like that of Doctor Walter E. Fernald or to 
work like that of Doctor Maria Montessori, insistence from the 
educational point of view is naturally and invariably focussed 
upon the individual. 

The Personal Attitude. — The individual, the individuality, the 
philosophical principle of individuation has something a little 
too subjective about it to appeal to the man in the street. And 
it is to be suspected that the physicians themselves do not suffi- 
ciently take into account (at all events early in their practical 
lives) the phenomena of personality. The reason why one pre- 
fers an old physician to a young man is not that he is likely to 
know more about the analysis of the human body (indeed, he 
is rather likely to be farther away from analysis than his younger 
colleague), but that he has acquired in life the sympathetic as- 
pect which the medical school failed to exhibit to him. 

A book like Doctor William Healy's "Individual Delinquent " 
brings up tort upon these matters. Written primarily, doubt- 
less, to counteract the formulation of the churches, Healy's book 
is also stimulating to the physician who is brought face to face 
with social problems of the handling of the individual which his 
medical knowledge and analytic insight do not cope with. Seguin 
himself, or even Pinel, would doubtless readily have granted the 
point just made. The present day, however, offers advantages 
which the days of Seguin did not offer. 

Mental Tests. — In the first place, we have methods of testing 
children's mentality in a systematic manner. The Binet Tests, 
made as they have been the victims of overpraise, on the one 
hand, and sweeping contempt, on the other, have beyond ques- 
tion for the first time put a different face on the situation, both 
in hospitals for psychopaths and in schools and courts. The 
Binet grade which the psychologist more or less confidently as- 
signs after an hour's study, is something that the commentator 
who knows more about the case than the examiner may not 
wholly agree with. The fortunate thing for the science of the 
situation is that the Binet grade is something concrete which 
you may at least disagree with. Meantime, these tests, which 
are being perfected from year to year, and applied, as by my col- 



A MEDICAL SYMPOSIUM 701 

league, Professor R. M. Yerkes, 1 in new preferable ways (with' 
new and more modern forms of casting up the results), are grow- 
ing in value, and it is safe to say that mental tests can no longer 
be dispensed with in the best clinics. 

Blood Tests. — But besides the educational point of view which 
has flowed from the work of Seguin, and the mental tests which 
have flowed from the lucid psychology of Binet, we have another 
arm at the present day. The best authorities agree that any 
adult with mental symptoms deserves at least a suspicion that 
he may be syphilitic. Accordingly, the Wassermann Test has 
become an indispensable aid to diagnosis in psychopathic hos- 
pitals and psychiatric clinics. Anywhere from 10 to 20 per cent 
of the intake of such hospitals and clinics may well prove to be 
syphilitic; certainly an important minority of cases. The data 
as to congenital syphilis and the syphilis of children and adoles- 
cents are not as yet so exactly statable. The fraction among 
children and adolescents is doubtless smaller than among the 
adults, but there is no question that an important field of re- 
search lies in the relation of syphilis to a certain number of the 
feeble-minded. Repeatedly in our Massachusetts experience 
cases have been found of congenital syphilitic in whom the ordi- 
nary clinical features were entirely absent. 

Somatic and Sociological Elements. — If we can now proceed 
to the somatic and sociological knowledge of cases, having the 
advantage of a Wassermann reaction (negative or positive), the 
Binet-Simon mental grading (or some similar grading), and ac- 
curate, progressive records of educational accomplishment by 
the feeble-minded, then we can proceed far more confidently to 
the bodies and brains of the cases which die, with the hope of 
learning something of importance. I wish to insist, therefore, 
that we are far more able in the year 1916 to do important work 
in the brain anatomy of feeble-mindedness than we were in the 
days of Seguin; far more than even in the long years which 
Bourneville spent upon the topic at the Bicetre. Indeed, it was 
only a little over ten years ago that books like Alfred W. Camp- 
bell's "Histological Studies on the Localization of Brain Func- 
tion" began to appear, offering us the normal topography of 
the cerebral cortex as a background upon which to study the 

1 The Yerkes Point Scale uses Binet material, it is true, but is otherwise 
based on a different conception of analysis and diagnosis. — M. P. E. G. 



702 APPENDIX 

changes and deficiencies in feeble-mindedness. It is true that 
the lamented Hammerberg twenty years ago did pioneer work 
of extraordinary excellence in this field. And it is a matter for 
congratulation that the field of feeble-mindedness should have 
stimulated such important work on normal cerebral topography 
from the histological point of view as is exhibited in the plates 
of Hammerberg's posthumous work printed at Upsala. 

Brain Anatomy in the Feeble-Minded. — The plan which Doc- 
tor Walter E. Fernald and I have formulated with respect to brain 
anatomy in the feeble-minded is to execute with every brain of 
a long series (twenty-three have at the present writing been in- 
vestigated) precisely the same technical devices. We think that 
conclusions of importance will hardly be reached before one hun- 
dred brains have been systematically examined. The autopsies, 
which are not always easy to secure, are systematically per- 
formed, with due attention to the organs of the soma, including 
the glands of internal secretion, and the brains, preserved in ap- 
propriate ways, are photographed systematically so that a per- 
manent record is obtained of each marking on the vertex and 
base, the two flanks, and the two mesal surfaces. The brains 
are then sectioned, and again photographed in six or eight 
frontal views, according to the size of the brain in question. 
Histological preparations are made from chosen areas, preference 
being had for the moment to those areas about which the physi- 
ologists know most. The material is carefully preserved in such 
wise that further recourse may be had to it as successive problems 
may arise in connection with the material. For example, if in 
a certain region exudate is discovered, indicating an active process 
(perhaps unsuspected in life or at the autopsy), then further 
studies on adjacent material may be stringently necessary for a 
drawing of proper conclusions as to the congenital or acquired 
nature of some of the changes found. 

So far we are not particularly well able to evaluate the his- 
tological changes. The original conclusions of Hammerberg as 
to the relative importance of the so-called contraction spaces 
due to artificial shrinkage in preserving fluids and the com- 
parative unimportance of so-called distortion of cellular elements 
have probably been justified by modern work. Except in cases 
which turned out to be exudative and possibly syphilitic, we have 
so far come upon the richest leads in connection with certain 



A MEDICAL SYMPOSIUM 703 

gross appearances, such as the relative complexity of the con- 
volutions, the relative sizes of the corpus callosum in different 
cases, and the like. 

Correlation of Findings. — What we have tried to do is to cor- 
relate, first, the educational capacity of the subject; second, the 
psychometric level as indicated by the Binet or other tests; and, 
third, the convolutionary complexity of the brain. It has proved 
not impossible to arrange our comparatively short series of brains 
in very suggestive order. It will probably be going too far to say 
that the simpler the brain, the lower the educational capacity, 
and the lower the psychometric level. In the first place, psycho- 
metric level and pedagogical capacity do not always agree; but 
if we are able to triangulate these scholastic and special test data 
with the brain data, we are enabled in certain instances to get a 
more intimate view of particular cases. It is true, also, that 
we have not as yet been able to examine enough of the brains of 
the feeble-minded of the higher grade. This is a lack which the 
total literature exhibits. The only worker who has put a long 
life largely at the disposal of the brain anatomy of the feeble- 
minded is Bourneville, and his collection is comparatively defi- 
cient in these high-level cases. 

We are using as a background to this work the photographically 
recorded brains and the preserved material of over five hundred 
other cases of insanity, epilepsy, criminality, and the like, even 
including certain so-called normal brains. But of all this mate- 
rial, it seems clear that the brain material of feeble-mindedness 
is the most interesting. 

Application to the Normal. — I do not need to insist upon the 
value to the education of the normal of any correlation, however 
slight, that we may be able to make from a comparison of brain 
appearances, educational capacity, and mental test level. One 
has only to think of the extraordinary interest of work like that 
of H. H. Donaldson done with the Laura Bridgman brain, now 
about twenty-five years ago. What an extraordinary comment 
upon the world's inefficiency it is that, although the brain is 
certainly an important tool in education, its study has been 
treated in a manner little short of stepmotherly. 



704 APPENDIX 



LIST OF CONTRIBUTORS TO THE MEDICAL 
SYMPOSIUM 

E. H. Arnold, M.D., 1466 Chapel Street, New Haven, Conn. 
Director, New Haven Normal School of Gymnastics; in- 
structor in orthopedic surgery, Yale Medical School; chief 
of the Orthopedic Clinic, New Haven Dispensary; ortho- 
pedic surgeon, Griffin Hospital, Derby, Conn., etc. 

Wm. F. Blake-Burke, M.D., "Watchung Crest," Plainfield, N. J. 
Late school physician, "Herbart Hall"; medical superin- 
tendent, "Wetumpka," Watchung Crest, Plainfield. 

John Adams Colliver, A.B., M.D., 412 West 6th Street, Los 
Angeles, Cal. Specialist in children's diseases; late presi- 
dent of Southern California Medical Society; late examin- 
ing physician to Los Angeles County Juvenile Court; late 
member of boards of education, etc. 

C. Ward Crampton, M.D., 157 East 67th Street, New York. 
Director of physical education, Department of Education, 
New York City. 

Frederic J. Farnell, M.D., 59 Blackstone Boulevard, Providence, 
R. I. Psychiatrist, Providence public schools; neuropatho- 
logist, Butler Hospital for the Insane; neuroserologist, State 
Hospital for the Insane; assistant neurologist, Rhode Island 
General Hospital, etc. 

Otto Glogau, M.D., 1320 Madison Avenue, New York. Assist- 
ant ^otolaryngologist, Vanderbilt Clinic, College of Physi- 
cians and Surgeons, Columbia University; otologist, Odd 
Fellows Home, Tuckahoe, N. Y., etc. 

Abraham Jacobi, M.D., 19 East 47th Street, New York. The 
Nestor of American medicine, specialist in children's dis- 
eases. 

Howard A. Knox, M.D. Assistant surgeon, U. S. Public Health 
Service, Ellis Island; temporarily detailed assistant physi- 
cian to the Psychiatric Institute of the New York State 
Hospitals. 

Edward S. Krans, A.B., M.D., 920 Park Avenue, Plainfield, 
N. J. Attending physician, Muhlenberg Hospital ; assistant 
director, Antituberculosis League of Plainfield; attending 
physician, Plainfield Open-Air School. 



A MEDICAL SYMPOSIUM 705 

F. Park Lewis, M.D., 454 Franklin Street, Buffalo, N. Y. 

Ophthalmologist to the Buffalo State Hospital; president, 
Board of Managers of the State School for the Blind; former 
president of the American Association for the Conservation 
of Vision, etc. 
E. Bosworth McCready, M.D., Pittsburg, Pa. Director, "Wild- 
wood Hall," Pa.; pedologist, South Side Hospital and Gusky 
Orphanage and Home, Pittsburg. 

D. C. Main, M.D., Alfred, N. Y. Specialist in nervous and 

mental diseases; member, National Association for the 
Study of Epilepsy, etc. 

G. Hudson Makuen, M.D., Philadelphia, Pa. Professor of de- 

fects of speech, Philadelphia Polyclinic and College for 
Graduates in Medicine. 

Ross Moore, A.B., M.D., 718 Brockman Building, Los Angeles, 
Cal. Attending neurologist to Los Angeles County Hos- 
pital; associate professor of neurology in Los Angeles De- 
partment of Medicine of the University of California, etc. 

M. Neustaedter, M.D., Ph.D., 121 5 Park Avenue, New York. 
Lecturer in neurology, New York University and Bellevue 
Hospital Medical College. 

B. Onuf, M.D., Park Ridge, N. J. Specialist in nervous and 
mental diseases; medical director, "The Oak," Park Ridge, 
N.J. 

A. Emil Schmitt, M.D., 50 Central Park West, New York. 
Past chief medical and sanitary officer, Nile Reservoir 
Works, Assuan, Egypt; past instructor, operative surgery, 
Columbia University Medical College; past attending sur- 
geon, German Hospital, O. P. D., etc. 

E. E. Southard, M.D., Boston, Mass. Director, Psychopathic 

Institute; pathologist, State Board of Insanity. 

Theodore Toepel, M.D., Atlanta, Ga. Member of American 
Association of Industrial Physicians and Surgeons, etc. 

Arthur W. Weysse, A.M., M.D., Ph.D., 421 Marlborough Street, 
Boston, Mass. Professor of experimental psychology and 
lecturer on venereal diseases, Boston University; fellow of 
the American Academy of Arts and Sciences. 

Ira S. Wile, M.D., 230 West 97th Street, New York. Com- 
missioner of Education, New York City; associate editor 
of American Medicine; lecturer in educational hygiene, New 



706 APPENDIX 

York University; instructor in dietetics, Columbia Univer- 
sity. 

Tom A. Williams, M.B., CM. (Edinburgh), 1704 N Street, 
N. W., Washington, D. C. Lecturer in nervous and mental 
diseases, Howard University, Washington, D. C; corre- 
sponding member Soc. Neurol, et Psychol., Paris, etc.; 
neurologist to Freedmen's and Epiphany Hospitals. 

Thomas D. Wood, M.D., Columbia University, New York. 
Professor of physical education, Columbia; chairman, 
Committee on Health Problems in Education of the Na- 
tional Council of Education, etc. 

John Dutton Wright, M.A., 1 Mount Morris Park, West, New 
York. Founder and principal of the Wright Oral School 
for the Deaf; director of the American Association to Pro- 
mote the Teaching of Speech to the Deaf; editor of the 
"Department of the Deaf" in the Laryngoscope, etc. 

Arthur Zentler, D.D.S., 8 West 40th Street, New York. As- 
sistant surgeon, Department of Oral Surgery, New York 
Nose, Throat and Lung Hospital (advanced courses for 
practitioners, Columbia University); instructor in oral 
surgery, New York Postgraduate Medical School, etc. 



APPENDIX III 

FIRST AND SECOND YEAR DATA OF P. E. G. 1 

First Year 
days 

10: Prefers light to darkness. 

12: Smiles. 

13: Follows movements with his eyes. 

15: Croons to himself. 

17: Raises his head. 

22: Supports himself on his elbows, holding head up. 

24: Pushes deliberately against resistance (his mother's hands) 
with his feet. Follows voices with turn of head. 

26 : Turns all the way around, lying on his back. Takes liquid 
from spoon. 

36: Plays with his father, opening and closing eyes, as if going 
to sleep, peeping through half-closed lids, etc.; appre- 
ciates the fun fully. 

38: Laughs aloud; turning his head away quickly as if teasing. 

45: Knows father, recognizing him immediately. 

46: Holds his hair-brush tightly, waving it to and fro, as if try- 
ing to use it. 

57: In his carriage, he always prefers to be wheeled over the 
roughest roads on his mountain home. 

58: Minds his father's talk. 

62: Connects his father's getting out of bed in the morning 
with his father's getting dressed and then playing with 
him. 

63 : Simultaneous impulse gives way to independent and alter- 
nate movements. Purposeful movements of head. 
Imitates mother's lullaby song to him, in almost per- 
fect rhythm. Loves music. 
117: First speech sound, intelligently connected with function. 

l Cf. pp. 115/. 
707 



708 APPENDIX 

DAYS 

121 : Discovers that rattle turns on pivot between forked ends — 
holds handle in one hand and tries to turn rattle wheel 
with other. Never sticks playthings in his eye, never 
hurts himself that way — has from the start had perfect 
adjustment. Always jolly. Plays alone. Recognizes 
faces in mirror. 

132: Enjoys Christmas tree, catches at ornaments and holds 
them. Prefers colored things. 

143: Raises himself up to a sitting position. 

144: Strikes keys on piano intelligently, in good imitation of 
his elders. A perfect imitator. 

145: Tries to pick printed rose from wall-paper. Holds his bottle 
all alone. Imitates sounds; listens to speech and un- 
derstands much of what is said to him. Constantly 
and purposely investigates and experiments. Move- 
ments well co-ordinated. 

156: Moves his arms in good-by greeting. 

159: Follows song in perfect rhythm. Follows simple directions. 

160: Speaks the German words ach, ja. 

166: Dips spoon into cup. 

178: Pulls his arms in and out of garment in dressing and un- 
dressing. 

179: Definite evidence that he never forgets what he once has 
done or observed. 

181: To the question, " Do you love your father? " he answers: 
" Ja." He understands both German and English. 

182: Drinks from cup. Rings bell. Swims around in big bath- 
tub full of water. 

199: Plays " hand over hand." 

206: Rises on his feet. 

209: Being held in arms of mother, he was told: " Mach' die 
Thiire auf! " (Open the door!) He opened the door, 
which was just a trifle open so that he could manage it 
with his hands. 

225: Plays many "make-believe" plays, like pretending to drink 
out of an empty glass, eating from an empty plate, etc. 

229: In going out with parents in big carriage, holds and moves 
reins as if driving. 

231: Distinctly free wrist movements. 



P. E. G.'S RECORD 709 

DAYS 

235: Wipes his face clean with handkerchief. 

249: Has six teeth. 

263: Finds things hidden under cloth, or in corner. Throws 
things. 

272: Follows the command, " Hands down," in gymnastic play. 

275: Plays with his image in mirror, recognizing " baby." 

276: Feeds himself with spoon. 

277: Pulls chain to turn electric light on and off. Folds his 
hands. Stands up supporting himself. 

301: Sitting in his high -chair, from which he has been dropping 
plates, cups, spoons, etc., when through with his meal, 
for days, he discovers, while dangling his enamel-ware 
platter over the edge of his " table " ready to drop it, 
that it would make a noise in hitting against the chair. 
Immediately he looks, tries it again, and again, and after 
this amuses himself in making the noise with other 
things instead of dropping them. This is an example 
of his observation and experimenting. 

312: Is mostly constructive in all his play; rarely breaks or de- 
stroys a thing. Shows good association of ideas and 
skill in play. Fond of driving, holding and using reins 
and whip. Has ridden on horse, dog, calf, and is fearless. 

317: Pulls his shirt over his head. Throws ball back to play- 
mate with both hands. Misses his father, who has gone 
on a long trip, holding out his arms for him to come 
back. Knows his father's picture. 

333: Stood up alone in moving carriage, holding on to dash- 
board. Plays with dog, enjoying a game of teasing and 
fooling him. 

361: Says "ank 00" (thank you). 

364: Pours water from bottle into cup and drinks. 

Second Year 

On tenth day he took his first walking step. He had been 
quite heavy, so that early walking had been discouraged. At 
fourteen and a half months he began really to walk. A month 
later he marched to the sound of a drum, " right, left." Built 
with large hollow cubes (nest), also balancing himself, stepping 
from one to the other. 



710 APPENDIX 

His vocabulary at one year, four months: Mamma, my mam- 
ma, papa, dada, gaga (all three meaning his father) ; Hei (name 
of his brother Heinz), Oward (Howard), Doctor, moo-cow (mean- 
ing also horses), kittie, chickie, quackquack (duck), doggie, 
wawa (water), baba, bebe (baby), byebye, nein (German for no), 
ja (yes), ach, ticktick (watch), hot, left-right (indistinct), 
c(r)ackers, a(ll) right, (th)ank (y)ou, Robert, ah-ah (for water 
and other things), ta-ta (also meaning thank you, water, etc.). 

Enjoys his second Christmas wonderfully. Loves his tree. 

At seventeen and a half months he plays in sand-heap with 
shovel and bucket. Walks up the greater part of hill (four hun- 
dred feet ascent). Is most interested in living things, especially 
moo-cows, by which he means mostly horses, cows, and other 
four-footed animals, except dogs and cats. He understands 
practically everything, does little errands, bringing things, etc. 

At nineteen and a half months he picks his first leaf. From 
now on much interested in flowers, and other growing things, 
picking them, bringing them home, insisting on having them put 
in water, etc. 

He will always choose rocky and steep paths, looking for diffi- 
culties to be overcome rather than shirking them. 

When twenty months old he discovers that a family at foot 
of hill has a pony. He makes daily pilgrimages down the hill 
to see and admire the animal until it is bought for him. He loves 
his pony and has the absolute sense of proprietorship. On his 
first ride in pony-cart, pony first runs away. He is not fright- 
ened, but ready to get back into the cart as soon as animal is 
under control. 

When a little over twenty-one months old he has his first 
automobile ride. From now on he is passionately fond of 
machines. 

At twenty- two months he is a wild, happy boy, full of play 
and tricks and sunshine. Always active, always in the open, 
loves the cold better than warm weather or warm clothing. 

At two years his vocabulary is about as follows: 

Mamma; papa; Pat; C(l)ara; shep (chef); Teddy (his pony); 
Paul (his own name); Max; Deewee (name given him by big 
brother) ; Mishi (Mr. Murphy) ; Brownie (name of his dog) ; God; 
George; Doctor; Princess (name of another dog); John; Howard; 
New Lork (New York — for another year, he substituted "1" for 



P. E. G.'S RECORD 711 

consonantal "y"); dada; mother; gaga; boy; man; girl; bebe; 
sport; tent; towel; rabbit; basket; horse; party; flag; ball; car; 
train; house; home; peach; feet; hands; pin; headache; wagon; 
cracker; bread; toast; stars; birthday; cake; hammick (ham- 
mock); piece; tea; duck; fish; piano; music; toothpick; cotton; 
soup; butterbread; heart; quackquack; milk; ice-c(r)eam; egg; 
penny; money; shoes; stockings; powder; hair; bucket; morn- 
ing; lady; stick; chocolate; cigar; Hosen (trousers); potato belly; 
Kartoff elbauch ; camp; bed; boat; Madchen (girl); moon; stairs; 
water; eyes; nose; mouth; berries; schwarze Beeren (blackberries) ; 
choochoo car; spoon; cup; bottle; night; bird; chickie; moo- 
cow; bad; good; happy; hungry; hot; cold; wet; dear; heavy; 
clean; dirty; still; fine; pretty; grand; more; mehr (more); 
enough; nass (wet); wet; open; big; little; two; bad man; bad 
boy; bad girl; Beebee hungry; hello; hurry; stay here; mamma's 
tent; my towel; way down; cease; hurrah; nein (no); no; ja 
(yes); yes; down there; bang; Papa's Junge (papa's boy); hoah; 
feet down; mamma sleep in there; I love lou; dear mamma, head- 
ache; other wagon heavy; look; tanzen (dance); dance; clean 
hand; dirty hand; Baby did it down there; ouch; more cotton; 
now; bad dog, go home; come Brownie; go on, papa; keep still; 
stop it; I will go now; no more; another piece; sleep fine; dear 
heart; eat; drink; now I go; byebye; good morning; poor lady 
sick; fly; hit; stop it; write it down; moon is gone; look at that; 
big bed; down-stairs; up-stairs; lie down; two eyes; get up; like; 
all gone; doggone; over there; move over; I don't like — ; how 
do? (how do you do?). 

A little later, there were these enrichments of his expressions: 
Climbed tree (after doing so) ; monkey in the tree (meaning him- 
self); Papa, help me; Baby, that's me; one papa; Papa, get up; 
ganz nass over there (all wet over there); two pins; two mans; 
papa's paper; water going down; baby's romper; Open (door) for 
papa; Baby (will) pick them up; pretty moo-cow; Baby's book. 



APPENDIX IV 

SPECIMENS OF REPORTS ON CHILDREN 
EXAMINED 1 

For a specimen report on an exceptionally bright child, cf. 
Appendix III. 

The following report on a boy of 14 was given to the principal 
of his school where he had been in the same primary grade for 
five years. 

Case 94. — This boy has a most decided handicap in his greatly im- 
paired vision, which the glasses he wears do not really correct. In 
addition, he is deaf [in his left ear and the hearing in his right ear is 
diminished. These two defects alone help to explain his failure in the 
ordinary school, where no attention can be paid to them. Whether the 
shortness of his visual and auditory memory and his practical illiteracy 
are due only to these two defects, or also to the fracture at the base of 
skull and the consequent inflammation of brain which he suffered 
when a child of two or three years, is doubtful. Of course there is a 
chance of a brain lesion having occurred at that time. 

He is certainly very backward in everything that refers to the use of 
words. His spelling is wretched owing to his lack of phonetic concept. 
His visual imagination is poor. A picture-story means little to him. 
While he can count, he cannot construct numbers on the abacus. In 
contrast to this is his quickness in identifying and adding figures with 
dice. 

On the other hand, to everything that implies action he responds well 
and shows good retention. He can carry out nine directions given 
simultaneously without a single break. Out of school his life is full of 
dramatic interest and active work. He has made his father's barn into 
a club-house where he inspires his companions to play cowboys and In- 
dians, where they have a moving-picture machine, etc. He helps his 
mother and does all kinds of work around the house. To have been kept 
in the same primary grade (third) for five years without proper attention 
to his special defects must have killed all his interest in school work. 

1C/.P.367. 
712 



REPORTS ON CHILDREN EXAMINED 713 

He had no incentive. His interests therefore centred on the out-of- 
school occupations where his energies had some outlet. Neither his 
teachers nor his parents seem to have known the real boy well enough 
to appreciate his needs. 

It is plain that this boy needed first of all proper medical atten- 
tion. The next step should be to take him out of his class and 
place him in an educational environment where his faculties 
may be sounded, and where he may develop his abilities in a 
normal and organized manner. A special class of the right kind 
may answer the purpose; but a removal into an entirely different 
regime, such as a laboratory school on the order of " Herbart 
Hall " can provide, would be far better, also because it would 
counteract the vitiating effect of the stigma which is now at- 
tached to him in his present environment, and because his par- 
ents have apparently not the slightest idea of what their boy 
really is. He has much in him to make eventually a useful and 
prosperous citizen. 

The following are a few examples taken from a series of rapid 
examinations made on pupils of a New Jersey township which is 
exceptionally well situated. These children are all from the 
poorer classes of that township. 

Case 95. — F. G., boy, 7^ years old. Boy has no home, is boarding, 
and has no regular home influences at all. Report is that he is nervous; 
perspires freely; suffers from biliousness and headaches; has had inflam- 
mation of bowels and much bronchial trouble. Disobedient, but very 
unhappy when punished. Pupil of first grade with an excellent record 
in art, manual work, writing and story-telling, but backward in reading 
and number. 

Clinical Findings. — Diminished vision in right eye; apt to confuse 
color names, either because he is color-blind, or because he has no confi- 
dence in his own judgment. Visual and aural memory very defective. 
The same lack of memory-power is shown in his attempts to follow a 
series of simultaneous directions. 

Immature in understanding of language elements, but in contradic- 
tion to the school report is found to read rather well and understandingly 
from the primer, with excellent expression. Can also tell stories from 
pictures very nicely. In number-work he is slightly behind his age, but 
exhibits fair ability to learn. He surprised most particularly in his ra- 
tional and prompt solution of the form-board problem, and by his han- 
dling of the picture-arrangement test, which he would have undoubtedly 



714 APPENDIX 

solved completely had it not been for his lack of confidence in his own 
judgment (cf. naming of colors). He showed fair idea of construction, 
and drew crudely but naturalistically, in perspective, and with much 
detail and action. He carries an air well. 

The boy is slightly retarded, of a constructive and artistic type, and 
perfectly able to get along in school if he is given training commensurate 
to his needs. He needs loving care and home life, eventually in a good 
institution. His bodily condition requires medical attention. 

Case 96. — A. W., girl, 10 years old. One of twelve children, burdened 
with bad heredity and handicapped by filthy home conditions. Has had 
rheumatism in knee, and is suffering from constant headaches. Still 
in second grade, with very poor progress, although she is good and 
obedient. Does well in manual work. 

Clinical Findings. — Tactile sense practically undeveloped. Has ade- 
noids and enlarged tonsils. Her teeth are neglected. She has a dis- 
tinct speech defect. 

Her visual and auditory senses are normal, but her memory is very 
weak. While she has some power of primitive association, her general 
intelligence is very low. She has a good idea of form, but no idea of 
construction. Purely mechanical in execution of manual tasks. Her 
drawing is crude, primitive, and helpless. The only spark of real intelli- 
gence was shown in her correct arrangement of the picture test, which 
would evidence a certain amount of cunning, at least. 

Owing to her defective intelligence and adverse home conditions, it 
would seem best to place her under custodial care, especially as there is 
moral danger ahead of her. Medical attention may bring some relief. 

Following are a few cases of brothers and sisters which illus- 
trate the influences of heredity and home environment even 
more strikingly: 

Cases 97 and 98. — D. B., girl, 13 years old, and W. B., her brother, 
11 yi years old. Poor and neglected home conditions, with many adverse 
influences. 

D. is the oldest of six children. In spite of the dirtiness of her home, 
she keeps herself clean, in contrast to her filthy-looking brothers, of 
whom only one was examined. She is emotional, does not seem strong, 
and the condition of her blood is not good. She suffers from sick-head- 
aches, ill-healing wounds, menstrual troubles, and enlarged tonsils. 
She is still in the third grade, and her school progress is reported as un- 
satisfactory. 

Clinical Findings. — Her visual and auditory memory very limited; 
she cannot retain units in her mind sufficiently securely to organize them. 
Willing enough, but hesitating and distrusting herself in all she does. 



REPORTS ON CHILDREN EXAMINED 715 

Command of oral language good; shows some reasoning power. In 
fact, her quickness in sizing up a situation and in doing some other judg- 
ment tests was surprising as compared with some of her failures. She 
is well capable of following a long list of simultaneous directions, and 
when given time and some suggestions to start her, is able to solve some 
of her practical problems satisfactorily. 

If she could be given the opportunity of healthful environment and 
training, she would have a fair chance of redeeming herself. Institutional 
care (not custodial) would be best for her under the circumstances. 
Since she is the oldest child, she is kept home from school the greater part 
of the time, and when she does attend, she is kept busy out of school 
hours, helping with the household and the other children, thus being de- 
prived of time for rest and healthful play, and of the opportunity of 
concentrating on her educational needs. She also requires medical 
attention. 

W., her brother, is in the same grade (!), and the work he does is 
generally poor, except in number, writing, and manual work. 

Clinical Findings. — Health fair, nutrition poor. Enlarged tonsils. 
In height and weight he is more like a boy of 13. Left-handed. Sus- 
picion of astigmatism which, if present, may account for his difficulty 
in spelling and reading. Visual and auditory memory unreliable in 
matter of order, memory span short. Of the primary word-picture, he 
recalled all of the thirty-one images; of the elementary one, only sixteen 
out of twenty-eight. This is, however, a fair showing as compared with 
his memory for detached units. His train of ideas is logical, and he 
gives sufficient evidence of rational thought in many ways. He under- 
stands a situation, and has good ideas of form and construction. Prompt 
and eager in response. Difficulties discourage him easily, but he is 
ready to try when encouraged. Of an active and inventive type, hav- 
ing some ability in drawing, with an interesting method of his own. 

Needs encouragement and special attention, possibly first in a special 
class, better in a special school (home school). He has sufficient intel- 
lectual and constructive stamina to become an intelligent and useful 
member of society if the effect of his home conditions can be overcome. 

Cases 99 and 100. — R. B., girl, 13 years old, and T. B., boy, her brother, 
io}4 years old. 

R. B. is the oldest of six children, of whom five are living. Home 
conditions very poor and filthy, and she is neglected in body and dress. 
No diseases reported. Second-grade pupil. 

Clinical Findings. — Looks frail and poorly nourished, with dark circles 
under her eyes. Undersized. Teeth very poor. 

While her vision and hearing seem normal, there is doubt as to her 
ability to hear articulate sound accurately. Visual and auditory memory 
weak; can retain more UDits by sight than by hearing. Power of asso- 



716 APPENDIX 

ciation fair. Reading and spelling bad; has no conception of phonics. 
Oral expression disconnected and vague. 

On the other hand, she shows that she understands well what she reads, 
and gave most surprising evidence of good reasoning ability, of the power 
of quick judgment, and of almost immediate perspective of a situation 
(in the picture-arrangement test). Prompt and eager in her response, 
and apparently perfectly capable of learning. Has a good mathematical 
mind, and seems to be naturally active and progressive. 

She needs first of all removal from her unhygienic home and an op- 
portunity to live a healthy life. A parental school will do great things 
for her, but she will also do well in a special class if she can be taken care 
of away from her home. 

T. B., her younger brother, is the product of the same unfortunate 
home conditions, of course. Has been subject to many diseases, includ- 
ing stomach troubles, rheumatism, and convulsions. His left eyelid 
droops, and vision is weaker in left than in right eye. Diminished hear- 
ing in right ear. Suffers from chills and fever, and acts as if he were out 
of his mind when thus affected. Conduct is good. In second grade, 
like his sister, and school progress slow. 

Clinical Findings. — His physical condition alone would be a sufficient 
cause of his mental torpidity. His memory is weak, and he is very 
immature and helpless in oral expression. His enunciation is faulty, 
either from imitation of poor language, or from lack of accurate concep- 
tion. Number concept underdeveloped. 

On the other hand, like his sister, he showed some good judgment and 
the ability to approach problems of situations with a rational process, 
so that he cannot be considered mentally defective in the full sense of 
that term. He exhibited interesting constructive ability and originality 
in building. His drawing is primitive. 

He is certainly very backward for his age, and needs special training 
badly, preferably in a parental school or similar institution. It would 
seem, however, that attention to his bodily needs, removal from his bad 
home environment, and special training will develop his latent faculties 
as in the case of his sister. 

Cases 101 and 102.—/. U '., boy, about 13 years old, and R. U ., his 
brother, nearly n years old. Both are the products of a very unfor- 
tunate heredity and home environment, with immorality, filth, and 
neglect. 

J. U. is in the fourth grade, and does excellent work in number, being 
"fair" to "poor" in everything else, except manual work, which he does 
well. 

Clinical Findings. — Undersized and underweight; nutrition poor. 
Vision so defective that he cannot see clearly. Left ear slightly affected, 
and he has a general difficulty in catching articulate speech. Does not 



REPORTS ON CHILDREN EXAMINED 717 

locate sound well with his left ear. Teeth very defective. His speech 
is much affected by these conditions. Tactile sense underdeveloped. 
Visual memory slightly better than auditory memory, sufficiently so to 
make him more dependent upon his vision than upon his hearing. But, 
as vision is defective, his " eye-mindedness " is rather a drawback. 

Language expression poor. But he understands directions and the 
content of stories. He showed surprising ability in the completion test 
and in the logical categories. His mathematical conception is good, 
but he does not readily grasp a situation. Good idea of form, but very 
inaccurate in construction. In drawing, he is crude but has the idea of 
perspective and action. 

If this boy, with his gifts and defects, cannot be removed from his 
home environment and placed under institutional care of the right kind, 
he will probably grow up to be a menace to society. His physical defects 
need medical attention. 

R. U. is still in the second grade and his school progress is poor all 
around. 

Clinical Findings. — He is undernourished and neglected. Teeth need 
attention badly and he has a speech defect similar, it is reported, to his 
mother's. Visual and auditory memory weak. Vision in right eye 
suffers from rapid fatigue; this eye seems also to have a restricted field 
of vision. Hearing in left ear diminished. 

Almost illiterate and his idea of number is limited, although it would 
seem that here he is teachable. Good idea of form, but little concep- 
tion of construction. His graphic expression is interesting as he is plainly 
in the "picture-writing" stage. Language undeveloped and judgment 
distinctly primitive. 

The condition of this boy is most regrettable, and no school instruction 
will be of much help to him unless he is removed from his home environ- 
ment and his physical handicaps are attended to. He seems teachable 
to some extent, but little definite can be stated under present circum- 
stances. Must have institutional care. 

A few characteristic cases from other places may be added. 
Only such are selected as show possibilities in spite of apparent 
school failure. 

Case 103. — J. E. G., boy, 7 years old. Reported as being in Grade iB, 
making no progress in school at all, owing to sleepiness and total incapa- 
bility. He never had any schooling before fall the previous year, having 
been in his class just that one term. His home conditions seem to be 
fair. No diseases are reported except that the teacher finds he is con- 
tinually leaving the room, so that she suspects bladder trouble. His 
teeth need attention. 



718 APPENDIX 

Clinical Findings. — Sense reactions normal, but memory span is short. 
His train of ideas is meagre and wandering, although his vocabulary is 
fairly good. He cannot read, write, or draw. He has, however, a good 
idea of form and quite some original conception of construction. His 
conception of number does not go beyond three or four (just as his mem- 
ory span is confined to three or four units). On the other hand, he has, 
owing to his good idea of form, a fine conception of comparative lengths. 
The most surprising feature of the mental life of this child is that in the 
tests of performance and judgment he shows an intelligence beyond his 
years. He has a fine sense of language and of sentence construction. 

There is no question that this interesting boy is full of capabilities 
which must be brought out by encouragement and special training. His 
response is slow and halting, but when once started he surprises the 
examiner by the good work he can do. His greatest obstacle is his 
timidity and diffidence. He seems afraid of doing anything. He will 
not move from one place to another upon a simple direction, but has to 
be led by hand or be encouraged by another person going with him. 
This gives the impression of a psychopathic condition which suggests 
an early examination by a specialist. There seem to be in his mind some 
dominant ideas which check the natural flow of his impulses. When 
once he is liberated from these checks he will undoubtedly develop con- 
siderable mental power. 

Case 104. — B. C, boy, n years old. Reported for being deficient in 
all school subjects except geography. Presents a nervous lack of atten- 
tion and a tendency to talk nonsense incessantly. From his history it 
would seem that there is some defect on the mother's side; she cannot 
talk correctly, but the report gives no reason for this condition. He is 
suffering from a chronic inflammation around the left eye, and suffers 
from chronic catarrh. 

Clinical Findings. — Vision unimpaired. The tendency to talk non- 
sense was not observed during the examination. Very backward in 
written language and also in reading. Yet he has certainly a very good 
command of oral language and shows logical thought in many ways. 
In rational application he is distinctly normal. He has a good memory 
for mental images and for simultaneous directions. This would indi- 
cate that he would develop good attention and concentration if his in- 
terest can be aroused. His train of ideas is natural and normal. Has 
a good idea of number and a fair conception of construction. 

His school work has not touched him, apparently; but he has cer- 
tainly possibilities which can be developed by proper educational methods 
even without "special" class work. 



BIBLIOGRAPHY 

OF SOME OF THE BOOKS, PAMPHLETS, AND ARTICLES CONSULTED 
IN THE PREPARATION OF THIS BOOK, OR SUGGESTED FOR 
COLLATERAL READING 

I. CLASSIFICATION 

Bronner, Augusta F. — "What Do Psychiatrists Mean?" The 

Journal of Nervous and Mental Diseases, July, 191 6, 

Boston. 
Groszmann, Waldemar Heinrich. — "The Position of the Atypical 

Child." The Journal of Nervous and Mental Diseases, 

July, 1906. 
Holmes, Arthur, Ph.D. — "Classification of Clinic Cases." The 

Psychological Clinic, April 15, 191 1. 
Kohs, Samuel C. — "The Borderlines of Mental Deficiency." 

Faribault, Minn., Journal of Psycho- Asthenics, March 

and June, 1916. 

II. SYSTEMS OF TESTS 

"Applying the Binet-Simon Test to Blind Children." Vine- 
land, N. J., The Training School Bulletin, October, 1916. 

Binet, Alfred, and Simon, Th. — "A Method of Measuring the 
Development of the Intelligence of Young Children." 
Authorized translation by Clara Harrison Town, Ph.D. 
Chicago Medical Book Co., 1913. 

"Recommendations on the Binet." New York, Ungraded, 

June, 1915. 

Bruckner, Leo, and King, Irving. — "A Study of the Fernald 
Formboard." The Psychological Clinic, February 15, 
1916. 

Campbell, Mary R. — "Suggestions and Methods for Making a 
Preliminary Survey of Public Schools." Proceedings, 
National Education Association, 19 14. 
719 



720 BIBLIOGRAPHY 

Chassell, Laura M. — "Tests for Originality." The Journal of 
Educational Psychology, June, 1916. 

Clark, Taliaferro, M.D. — "Mental Examinations of School 
Children." Public Health Reports, August 25, 1916, 
Washington, D. C. 

Dearborn, W. F., Anderson, J. E., and Christiansen, A. O. — "Form 
Board and Construction Tests of Mental Ability." The 
Journal of Educational Psychology, October, 1916. 

Doll, E. A. — "Form Board Speed as Diagnostic Age Tests." 
Journal of Psycho- Asthenics, March and June, 19 16. 

Ellis, Frederick W. — '"Mental Age' and 'Physiological Age' in 
Interpreting the Binet and Simon Age Scale." New 
York, Ungraded, June, 191 5. 

Report of the New York Neurological Institute, 1913. 

Fernald, Walter E., M.D. — "The Diagnosis of the Higher Grades 
of Mental Defect." Baltimore, American Journal of In- 
sanity, January, 1914, The Johns Hopkins Press. 

Groszmann, Maximilian P. E. — "The Study of Individual 
Children." Plainfield, N. J., National Association 
for the Study and Education of Exceptional Children, 
1912. 

Hamilton, Allan McLane. — "Mental and Physical Tests for 
Boys." New York Times Magazine, March 19, 1916. 

Hinckley, Alice C. — "The Binet Tests Applied to Individuals 
over Twelve Years of Age." Baltimore, The Journal of 
Educational Psychology, January, 1915. 

Huey, Edmund Burke, Ph.D. — "Backward and Feebleminded 
Children." Baltimore, Warwick & York, 1912. 

Kelley, Truman Lee. — "A Constructive Ability Test." Balti- 
more, The Journal of Educational Psychology, January, 
1916. 

Kelly, F. J. — "The Kansas Silent Reading Tests." The Journal 
of Educational Psychology, February, 19 16. 

King, Irving, and Gold, Hugo. — "A Tentative Standardization 
of Certain 'Opposite Tests.'" The Journal of Educational 
Psychology, October, 1916. 

Knox, Howard A., M.D.— "Tests for Mental Defects." Wash- 
ington, The Journal of Heredity, March, 1914. 

Kohs, Samuel C. — "The Binet Scale and Borderline Cases." 
The Training School Bulletin, October, 1916. 



BIBLIOGRAPHY 721 

"Mentality Tests." A symposium. The Journal of Educational 
Psychology, April, 1916, f., Baltimore, Md. 

Miles, Walter R., and Butter-worth, Julian E. — "A Tentative 
Standardization of a Completion Test." 

Pritchard, Margaret S. — "Testing from a Psychological Point 
of View." Philadelphia, The Teacher, April, 191 5. 

Pyle, William Henry, Ph.D. — "The Examination of School Chil- 
dren. A Manual of Directions and Norms." New York, 
The Macmillan Co., 1913. 

Schmitt, Clara. — "Cooperation of Psychologist and Physician." 
The Journal of Nervous and Mental Diseases, July, 
1916. 

Seashore, Carl E. — "Elementary Tests in Psychology." The 
Journal of Educational Psychology, February, 19 16. 

Stern, William, Ph.D. — "The Psychological Methods of Testing 
Intelligence." Translated from the German by G. M. 
Whipple. Baltimore, Warwick & York. 

Terman, Lewis M., Ph.D.— "Review of Meumann Tests on 
Endowment." Faribault, Minn., The Journal of Psycho- 
Aslhenics, December, 1914; March and June, 191 5. 

and Knollin, H. E. — "Some Problems Relating to the De- 
tection of Borderline Cases of Mental Deficiency." The 
Journal of Psycho- Asthenics, XX, 1-2. 

"The Stanford Revision of the Binet-Simon Intelligence 

Scale." Baltimore, Warwick & York, 191 7. 

Trabue, M. R., Ph.D. — "Completion Test Language Scales." 
New York, Teachers College, Columbia University, 
1916. 

Wallin, J. E. Wallace. — "Age Norms for Psycho-Motor Capac- 
ity" (Seguin Formboard). The Journal of Educational 
Psychology, January, 19 16. (Doctor Wallin has also 
written a number of articles on the Binet Tests.) 

"Experimental Studies of Mental Defectives." Baltimore, 

Warwick & York, Inc. 

Whipple, Guy Montrose, Ph.D. — "Manual of Mental and 
Physical Tests." Baltimore, Warwick & York, 1910. 

Yerkes, Robert M., Ph.D., and Rossy, Cecilio S., M.A.— "A 
Point Scale for the Measurement of Intelligence in Ado- 
lescent and Adult Individuals." The Boston Medical and 
Surgical Journal, April 19, 191 7. 



722 BIBLIOGRAPHY 

Yerkes, Robert M., Ph.D., Bridges, James W., and Eardwick, 
Rose S. — "A Point Scale for Measuring Mental Ability." 
Baltimore, Warwick & York, 191 5. 

III. BACKWARD CHILDREN 

Ayres, Leonard P. — "Laggards in Our Schools." New York, 
Charities Publication Co., 1909. 

Commons, Clara. — "A Normal Backward Child in the Public 
School." Vineland, N. J., The Training School Bulletin, 
November, 1916. 

Holmes, Arthur. — "Backward Children." Indianapolis, The 
Bobbs-Merrill Co., 1915. 

Morgan, Barbara Spofford. — "The Backward Child. A Study 
of the Psychology and Treatment of Backwardness." 
New York, G. P. Putnam's Sons, 1914. 

Noll, Heinrich.— " Formale und materiale Intelligenzdefecte als 
Hemmungen im ersten Leseunterrichte und eine die- 
sen Defecten angepasste Leselehrmethode." Langen- 
salza, Zeitschrift fiir Kinder j or schung, 191 5. 

Willich, Ernst. — "Ueber das Interesse eines schwachbegabten 
Jungen." Zeitschrift fiir Kinderjor schung, 1914. 

IV. PHYSICALLY DEFECTIVE CHILDREN 

Blind, New Jersey Commission for the. Report for the year 
1913, Trenton, 1914. 

Deaf: Garrett, Mary S. — "Directions to Parents of Deaf Chil- 
dren." 

"Helps and Hindrances of Deaf Children in Acquiring 

Speech and Language at the Natural Age." Philadelphia, 
published by the author. 

Home for the Training in Speech of Deaf Children Before They 
Are of School Age. Twelfth Report, November, 1914, 
Philadelphia, Pa. 

Merritt, Prof. Fred D— "The Crippled Children's Law." 
Eugene, Ore., University of Oregon Bulletin, June, 1917. 

Otis, Edward O., M.D.— "The Physically Defective." Pitts- 
burg, The Journal of Sociological Medicine, June, 
1917. 



BIBLIOGRAPHY 723 

Pintner, Rudolf, and Pater son, Donald G. — "The Binet Scale 
and the Deaf Child." The Journal of Educational Psy- 
chology, April, 1915. 

Reik, Henry O., M.D. — "Safeguarding the Special Senses." 
Philadelphia, F. A. Davis Co., 191 2. 

Reports of Defective Children (Mental Defectives; the Anemic; 
the Tuberculous; the Blind; the Deaf and Dumb; the 
Crippled). Department of Education, City of New York, 

1914/- 
Wright, John Dutton— "What the Mother of a Deaf Child 
Ought to Know." New York, Frederick A. Stokes Co. 

V. PHYSIOLOGICAL CONDITIONS 

Baldwin, Professor Bird Thomas. — "Physical Growth and School 
Progress." U. S. Bureau of Education, Bulletin No. 10, 
1914. 

Bancroft, Jessie H. — "The Posture of School Children." New 
York, The Macmillan Co., 19 14. 

Crampton, C. Ward, M.D. — "Physiological Age: a Fundamental 
Principle." American Physical Education Review, March- 
June, 1908. 

"Anatomical or Physiological vs. Chronological Age." 

Pedagogical Seminary, June, 1908. 

Donaldson, Henry Herbert. — "The Growth of the Brain." New 
York, Chas. Scribner's Sons, 1895. 

Rotch, Thomas Morgan, M.D. — "The Development of the Bones 
in Early Life." Transactions of the Association of Ameri- 
can Physicians, 1909. 

"Roentgen Ray Methods Applied to the Grading of Early 

Life." American Physical Education Review, June, 1910. 

Stratz, Dr. C. H— "Der Korper des Kindes." Stuttgart, 
Ferdinand Enke, 1903. 

VI. CHILD HYGIENE 

Baur, Dr.med. Alfred. — "Die Hygiene des kranken Schulkin- 
des." Stuttgart, Ferdinand Enke, 1903. 

Burgerstein, Leo, Ph.D. — "School Hygiene." Translated from 
the German by Beatrice L. Stevenson and Anna L. von 
der Osten. New York, Fred. A. Stokes Co., 1915. 



724 BIBLIOGRAPHY 

Dresslar, Fletcher B., Ph.D. — "School Hygiene." New York, 

The Macmillan Co., 1914. 
Forsyth, David, M.D. — "Children in Health and Disease." 

Philadelphia, P. Blakiston's Sons & Co., 1909. 
Hutchinson, Woods, M.D.— "The Child's Day." Health Series, 

Book I. Boston, Houghton Mifflin Co., 1912. 
Montessori, Dr. Maria. — "Pedagogical Anthropology." Trans- 
lated from the Italian by Frederick Taber Cooper, New 

York, Frederick A. Stokes Co., 1913. 
Mueller, J. P.— "The Fresh-Air Book." New York, Fred. A. 

Stokes Co., 1910. 
Oppenheim, Nathan, M.D. — "The Care of the Child in Health." 

New York, The Macmillan Co., 1904. 
O'Shea, M. V., and Kellogg, J. H. — "Health and Cleanliness." 

New York, The Macmillan Co., 191 5. 

"Health Habits." Same. 

"Making the Most of Life." Same. 

"The Body in Health." Same. 

Rapeer, L. W., Ph.D. — "Educational Hygiene." Chas. Scrib- 

ner's Sons, New York, 191 5. 
Rotch, Thomas Morgan, M.D. — "Pediatrics. The Hygienic and 

Medical Treatment of Children." Philadelphia, J. B. 

Lippincott Co., 1896. 

VII. MEDICAL ASPECTS 

Biedert, Prof. Dr. Ph. — "Lehrbuch der Kinderkrankheiten." 
Stuttgart, Ferdinand Enke, 1902. 

Blue, Rupert (Surgeon-General). — "Report of Prevalence Dur- 
ing 1915 in Cities of over 100,000, of Gonorrhea and 
Syphilis." U. S. Public Health Report, Reprint no. 347, 
June 30, 1916. 

Heck, W. H. — "The Health of School Children." Contributions 
from American Medical Journals. I. U. S. Bureau of 
Education, Bulletin no. 4, 1915; II. Bulletin no. 50, 

1915- 
Hoag, Ernest Bryant, M.D.— "The Health Index of Children." 

San Francisco, Whitaker & Ray-Wiggin Co., 1910. 
Jacobi, A., M.D. — "Therapeutics of Infancy and Childhood." 

Philadelphia, J. B. Lippincott Co., 1903. 



BIBLIOGRAPHY 725 

Jacoby, George W., M.D. — "Child Training as an Exact 
Science." New York, Funk & Wagnalls Co., 1914. 

Knopf, S. A., M.D. — "Tuberculosis as a Disease of the Masses." 
Prize essay. New York, M. Firestack, 1905. 

"Tuberculosis a Preventable and Curable Disease." New 

York, Moffat, Yard & Co., 1909. 

"Is There Any Relation Between Tuberculosis, Mental 

Disease and Mental Deficiency?" Proa, N. J. Con- 
ference of Charities and Correction, 19 16. 

Lippert, Frieda E., M.D., and Holmes, Arthur, Ph.D. — "When 
to Send for the Doctor and What to Do before the Doctor 
Comes." Philadelphia, J. B. Lippincott Co., 1913. 

Marshall, John Sayre, M.D. — "Mouth Hygiene and Mouth 
Sepsis." Philadelphia, J. B. Lippincott Co., 191 2. 

MetchnikojJ, Prof. Elie. — "Immunity in Infective Diseases." 
Translated from the French by Francis G. Binnie. 
Cambridge, University Press (G. P. Putnam's Sons), 
1907. 

Still, George Frederick, M.D. — "Common Disorders and Dis- 
eases of Childhood." London, Henry Frowde, 191 2. 

Sykes, John F. J. — "Public Health Problems." London, Eng- 
land, The Walter Scott Publishing Co., Ltd., New York, 
Charles Scribner's Sons, 1910. 

Williams, Dawson, M.D., and Churchill, Frank Spooner, M.D. 
— "Medical Diseases of Infancy and Childhood." Phila- 
delphia, Lea Brothers and Co., 1900. 

Williams, Leonard, M.D. — "Adenoids, Nocturnal Enuresis and 
the Thyroid Gland." London, John Bale, Sons and 
Danielsson, 1909. 

Winterburn, Florence Hull. — "The Children's Health." New 
York, The Baker & Taylor Co. (Doubleday, Page & 
Co.), 1901. 

VIII. PSYCHOLOGICAL ASPECTS 

Arnold, Felix, Ph.D. — "Attention and Interest. A Study in 
Psychology and Education." New York, The Macmil- 
lan Co., 1910. 

Ayer, Fred C. — "The Psychology of Drawing." Baltimore, 
Warwick & York. 



726 BIBLIOGRAPHY 

Browning, William, M.D. — "The Etiology of Stammering, and 

Methods for Its Treatment." Brooklyn, N. Y., Neuro- 

graphs, vol. I, no. 4. 
Colvin, Stephen Sheldon, Ph.D. — "The Learning Process." 

New York, The Macmillan Co., 1914. 
and Bagley, William Chandler. — "Human Behavior. A 

First Book in Psychology for Teachers." New York, 

The Macmillan Co., 19 14. 
Ebbinghaus, Prof. Hermann. — "Grundzuege der Psychologic" 

Leipzig, Veit & Co., 1897. 
Elders. — "Die Heilung des Stotterns in Einzelfaellen, Lehr- 

gaengen und Schulklassen." Langensalza, Zeitschrift 

fiir Kinder f or schung, December, 1914. 
Groos, Prof. Karl. — "Die Spiele der Thiere." Jena, Gustav 

Fischer, 1896. 
Halleck, Reuben Post, M.A. — " Psychology and Psychic Culture." 

New York, American Book Co., 1895. 
Hollingworth, H. L. — "Experimental Studies in Judgment." 

New York, The Science Press, December, 1913. 
Home, Herman Harrell, Ph.D. — "The Psychological Principles 

of Education." New York, The Macmillan Co., 1914. 
Kirkpatrick, Edwin A. — "Genetic Psychology. An Introduc- 
tion to an Objective and Genetic View of Intelligence." 

New York, The Macmillan Co., 1909. 
Kohn, Dr.phil. Harry E. — "Zur Theorie der Aufmerksamkeit." 

Halle, Max Niemeyer, 1895. 
Ladd, George Trumbull. — "Outlines of Physiological Psychol- 
ogy." "New York, Chas. Scribner's Sons, 1891. 
March, John Lewis, A.M., Ph.D.— "A Theory of Mind." New 

York, Charles Scribner's Sons, 1908. 
Mateer, Florence, Ph.D. — "Child Behavior." Boston, Richard 

G. Badger, 1917. 
Oppenheim, Nathan, M.D. — "Mental Growth and Control." 

New York, The Macmillan Co., 1913. 
Parmelee, Maurice, Ph.D. — "The Science of Human Behavior. 

Biological and Psychological Foundations." New York, 

The Macmillan Co., 19 13. 
Scripture, E. W., Ph.D. (Leipzig)— "The New Psychology. ' 

London, England, The Walter Scott Publishing Co., 

Ltd.; New York, Charles Scribner's Sons, 1910. 



BIBLIOGRAPHY 727 

Scripture, E. W., M.D. — "Stuttering and Lisping." New York, 
The Macmillan Co., 1914. 

Scripture, May Kirk, and Glogau, Otto. — "Speech Conflict — a 
Natural Consequence in Cosmopolitan Cities — as an 
Etiological Factor in Stuttering." New York, The Jour- 
nal of Nervous and Mental Diseases, January and Feb- 
ruary, 1916. 

Sinclair, Samuel Bower, Ph.D., and Tracy, Frederick, Ph.D. — 
"Introductory Educational Psychology." Toronto, The 
Macmillan Co., 191 2. 

Starbuck, Edwin Diller, Ph.D.— "The Psychology of Relig- 
ion." London. England, The Walter Scott Publishing 
Co., Ltd.; New York, Charles Scribner's Sons. New 
edition. 

Starch, Daniel, Ph.D. — "Experiments in Educational Psychol- 
ogy." New York, The Macmillan Co., 1913. 

Stratlon, George Malcolm, Ph.D. — "Experimental Psychology 
and Its Bearings upon Culture." New York, The Mac- 
millan Co., 1903. 

Swift, Edgar James. — "Youth and the Race. A Study in the 
Psychology of Adolescence." New York, Chas. Scribner's 
Sons, 1912. 

"Mind in the Making." New York, Chas. Scribner's 

Sons, 1908. 

Witmer, Lightner, Ph.D. — "On the Relation of Intelligence to 
Efficiency." Philadelphia, The Psychological Clinic, May 

is, 1915- 

IX. NERVOUS AND PSYCHIC DISORDERS 

"Abnormal Psychology: Interpretations and Investigations." 

Boston, Richard G. Badger, 191 7. 
"Abnormal Psychology, Studies in." Series V. Selections from 

the Journal of Abnormal Psychology. Boston, Richard 

G. Badger, 1915. 
Adler, Herman M., M.D. — "Unemployment and Personality." 

Concord, N. H., Mental Hygiene, January, 1917. 
Balliet, Gilbert, M.D.— "Neurasthenia." Translated from the 

French by Dr. P. Campbell Smith. New York, Wm. 

Wood & Co., 1909. 



728 BIBLIOGRAPHY 

Beling, Christopher G.j M.D. — "The Insanity of Adolescence." 
New York Medical Journal, November 24, 1906. 

"The Relation of Dentistry to Neurology." Journal of the 

Medical Society of New Jersey, 1915. 

"The Borderland of the Psychoses." Ibid., 1916. 

"Psychopathic Hospitals and Clinics." Proc. N. J. Con- 
ference of Charities and Correction, 1916. 

Burrow, Trigant, Ph.D., M.D.— "The Philology of Hysteria." 
Chicago, The Journal 0} the American Medical Association, 
March n, 1916. 

Church, Archibald, M.D., and Peterson, Frederick, M.D. — "Ner- 
vous and Mental Diseases." Philadelphia, W. B. Saun- 
ders & Co., 1904. 

Clark, L. Pierce, M.D. — "Psychopathic Children." New York 
Medical Journal, 19 14. 

Collins, Joseph, M.D. — "The Genesis and Dissolution of the 
Faculty of Speech. A Clinical and Psychological Study 
of Aphasia." New York, The Macmillan Co., 1898. 

Cramer, Prof. Dr. A. — "Ueber die ausserhalb der Schule liegen- 
den Ursachen der Nervositat der Kinder." Berlin, 
Reuther & Reichard, 1899. 

Czerny, Prof. Ad. — "Die Entstehung und Bedeutung der Angst 
im Leben des Kindes." Langensalza, Zeitschrift fur 
Kinderforschung, XX, 1. 

Dubois, Dr. Paul. — "The Psychic Treatment of Nervous Disor- 
ders." Translated and edited by Drs. Jeliffe and White. 
New York, Funk & Wagnalls Co., 1909. 

"Self-Control and How to Secure It." Same publisher, 

1909. 

Farnell, Frederick J., M.D. — " Psychopathology of the Child." 
Quarterly Bulletin of the State Board of Health of Rhode 
Island, January, 191 5. 

For el, August, M.D. — "Hygiene of Nerves and Mind in Health 
and Disease." Translated from the German by Herbert 
A. Aikins, Ph.D. New York, G. P. Putnam's Sons, 
1907. 

Fox, Charles D., M.D. — "Psychopathology of Hysteria." Bos- 
ton, Richard G. Badger, 1913. 

Goodhart, S. Philip, M.D. — "The Recognition of Dementia Pre- 
cox." The Medical Record, May 21, 1910. 



BIBLIOGRAPHY 729 

Haberman, J. Victor, M.D. — "A Criticism of Psycho- Analysis." 
Boston, The Journal of Abnormal Psychology, October- 
November, 1914. 

Jacoby, George W., M.D. — "Suggestion and Psychotherapy." 
New York, Charles Scribner's Sons, 191 2. 

Jeliffe, Smith Ely, M.D., and While, Wm. A., M.D.— "Prin- 
ciples Underlying the Classification of Diseases of the 
Nervous System." The Journal of the American Medical 
Association, March n, 1916. 

Kahane, Dr. Heinrich. — "Der defekte Mensch. Zwang und 
Drang in der psychischen Mechanik." Wien, Georg 
Szelinski, 191 1. 

Knauer, Dr. A. — " Psychopathische Personlichkeiten." Miin- 
chen, J. F. Lehmann, 191 1. 

Lombroso, Cesare. — "The Man of Genius." London, England, 
The Walter Scott Publishing Co., Ltd.; New York, 
Charles Scribner's Sons, 1914. 

McClenahan, H. C, M.D. — "Rational Psychotherapy." Cali- 
fornia State Journal of Medicine, April, 1913. 

McComb, Rev. Dr. Samuel. — "Alcoholism as a Psychic Dis- 
order." Proc. N. J. Conference of Charities and Correc- 
tion, 1916. 

Mercier, Charles, M.B. — "Sanity and Insanity." London, 
England, The Walter Scott Publishing Co., Ltd.; New 
York, Charles Scribner's Sons, 191 5. 

Meyer, Adolf, M.D., Jelife, Smith Ely, M.D., and Hoch, August, 
M.D. — "Dementia Precox." Boston, Richard G. Bad- 
ger, 1911. 

Mills, Charles K., M.D. — "Nursing and Care of the Nervous 
and the Insane." Philadelphia, J. B. Lippincott Co., 

IQI5- 

Moll, Dr. Albert.— "Hypnotism." London, England, The Wal- 
ter Scott Publishing Co., Ltd.; New York, Charles Scrib- 
ner's Sons, 1913. 

Monkenmoller, Oberarzt Dr. — "Die Psychopathologie der 
Pubertatszeit." Langensalza, Zeitschrift fiir Kinder- 
forschung, XVIII, 1 and 2. 

Nadoleczny, Dr. Max. — "Die Sprach- und Stimmstorungen im 
Kindesalter." Leipzig, F. C. W. Vogel, 191 2. 

"Nine Family Histories of Epileptics in One Rural County." 



730 BIBLIOGRAPHY 

Eugenics and Social Welfare Bulletin no. VII, State 

Board of Charities, Albany, N. Y., 1916. 
Paton, Stewart, M.D. — "The City's Need of a Psychopathic 

Clinic. " The Journal of the American Medical Association, 

March 11, 1916. 
Patrick, Prof. G. T. W— "The Psychology of War." New York, 

The Popular Science Monthly, August, 1915. 
"Psychotherapeutics." A Collection of Monographs. Edited 

by Morton Prince, M.D., Boston, Richard G. Badger. 
Ribol, Theo. — "The Diseases of Personality." Chicago, The 

Open Court Publishing Co., 1891. 
Sachs, B., M.D. — "A Treatise on the Nervous Diseases of Chil- 
dren." New York, Wm. Wood & Co., 1895. 
Salmon, Thomas W., M.D. — "Some New Fields in Neurology 

and Psychiatry." Lancaster, Pa., The Journal of Mental 

and Nervous Diseases, August, 191 7. 
Schofield, Alfred T., M.D.— "Nerves in Disorder." New York, 

Funk & Wagnalls Co., 1903. 
Schwarz, Osias L. — "General Types of Superior Men." Boston, 

Richard G. Badger, 1916. 
Shaw, John C, M.D. — "Essentials of Nervous Diseases and 

Insanity." Revised by Smith Ely Jeliffe. Philadelphia, 

W. B. Saunders Co., 1910. 
Sidis, Boris, M.D. — "Philistine and Genius." New York, 

Moffat, Yard & Co., 1911. 
"The Foundations of Normal and Abnormal Psychology." 

Boston, Richard G. Badger, 1914. 
Spratling, William P., M.D. — "Epilepsy and Its Treatment." 

Philadelphia, W. B. Saunders & Co., 1904. 
Stelzner, Dr.med. Helenefriederike. — "Die Psychopathischen 

Konstitutionen." Berlin, S. Karger, 1911. 
Striimpell, Prof.-Ludwig. — "Die Padagogische Pathologic" 

Leipzig, E. Ungleich, 1892. 
"Subconscious Phenomena." A collection of studies. Edited 

by Morton Prince, M.D. Boston, Richard G. Badger, 

1910. 
Swift, Edgar James. — "Reflex Neuroses in Childen." American 

Physical Education Review, 1899. 
Taft, Jessie. — "Fortifying the Child Against Mental Disease." 

Albany, N. Y., American Education, September, 191 7. 



BIBLIOGRAPHY 731 

Talbot, Eugene S., M.D. — " Developmental Pathology. A Study- 
in Degenerative Evolution." Boston, Richard G. Bad- 
ger, 1915. 

"The Twenty-Third Annual Report of the Managers and Offi- 
cers of the Craig Colony for Epileptics." Albany, N. Y., 
J. B. Lyon Co., Printers, 191 7. 

"Transactions of the National Association for the Study 
of Epilepsy and the Care and Treatment of Epilep- 
tics." Several volumes. Edited by William Spratling, 
M.D. 

Tucker, Beverly R., M.D.— "Nervous Children." Boston, 
Richard G. Badger, 191 7. 

Waldstein, Louis, M.D. — "The Subconscious Self and Its Re- 
lation to Education and Health." New York, Charles 
Scribner's Sons, 1909. 

Walton, George Lincoln, M.D. — "Those Nerves." Philadelphia, 
J. B. Lippincott Co., 1909. 

"Why Worry?" Same publisher, 1913. 

Warner, Francis, M.D. — "The Nervous System of the Child." 
New York, The Macmillan Co., 1916. 

Wells, Frederic Lyman, Ph.D. — "Mental Adaptation." Con- 
cord, N. H., Mental Hygiene, January, 191 7. 

Westermayr, Arthur J. — "The Psychology of Fear." The Open 
Court, Chicago, April, 1915. 

Williams, Tom A., M.D. — "Psycho-Therapeutics." Boston, 
Richard G. Badger, 19 10. 

X. FEEBLE-MINDEDNESS 

Barr, Martin W., M.D. — "Mental Defectives. Their History, 

Treatment, and Training." Philadelphia, P. Blakiston's 

Son & Co., 1904. 
Berkham, Dr. O. — "Ueber den angeborenen und friih erwor- 

benen Schwachsinn." Braunschweig, F. Vieweg & Sohn, 

1904. 
Brandenburg, Dr. — "Zur Fursorge fur die Schwachsinnigen." 

Bielefeld, A. Helmich, 1890. 
Crafts, L. W. — "Bibliography of Feeble-mindedness in Its Social 

Aspects." Faribault, Minn., Journal of Psy cho- A sthenics, 

Monograph Supplement, March, 191 7. 



732 BIBLIOGRAPHY 

Doll, Edgar A., Ph.D. — "Clinical Studies in Feeble-minded- 
ness." Boston, Richard G. Badger, 1917. 

Femald, Walter E., M.D. — "The Growth of Provisions for the 
Feeble-minded in the United States.''' Concord, N. H., 
Mental Hygiene, January, 191 7. 

Goddard, H. H., Ph.D. — "The Improvability of Feeble-minded 
Children." Faribault, Minn., The Journal of Psycho- 
Asthenics, June, 1913. 

"School Training of Defective Children." Yonkers, N. Y., 

World Book Co., 1915. 

"Review of Feeble-Mindedness, Its Causes and Con- 
sequences." Vineland, N. J., The Training School Bul- 
letin, September, 1916. 

Groszmann, Maximilian P. E., Pd.D. — "Some Recent Changes 
in the Attitude towards the Problem of Mental Defect." 
New York, Educational Foundations, September, 191 7. 

Jacobson, Arthur C, M.D. — "Service from Imbeciles." The 
Medical Times, August, 1916, New York. 

Kuhlmann, F. — "What Constitutes Feeble-mindedness?" The 
Journal of Psycho- Asthenics, June, 191 5. 

Ordahl, Louise Ellison, Ph.D., and Ordahl, Geo., Ph.D.— "Quali- 
tative Differences Between Levels of Intelligence in 
Feeble-Minded Children." The Journal of Psycho- 
Asthenics, Monograph Supplement, vol. I, no. 2, June, 

1015- 
Porteus, S. D. (Melbourne). — "Mental Tests for Feebleminded: 
A New Series." The Journal of Psycho- Asthenics , June, 

1915- 
Rabinerson-Levine, Mme. — "Contribution Clinique et Statis- 

tique a l'etude des enfants anormaux des Ecoles primaires 

de Geneve." Universite de Geneve, Imprimerie et Litho- 

graphie Sonor S.A., 1914. 
Seguin, Edward, M.D. — "Idiocy and Its Treatment by the 

Physiological Method." New York, reprinted by the 

Teachers College, Columbia University, 1907. 
Sherlock, E. B., M.D.— "The Feeble-minded." London, Mac- 

millan & Co., Limited, 191 1. 
Shuttle-worth, G. E., M.D., and Potts, W. A., M.D.— "Mentally 

Deficient Children." Philadelphia, P. Blakiston's Son 

& Co., 1910. 



BIBLIOGRAPHY 733 

XI. DELINQUENCY AND CRIME 

"Annual Report of the County Court of Alleghany County for 
the Year 1916." Pittsburg. 

Bowers, Paul E., M.D. — "The Necessity for Medical Examina- 
tion of Prisoners at the Time of Trial." Pittsburg, The 
Journal of Sociological Medicine, June, 191 7. 

Bowler, Alida C. — "The Trabue Completion Test as Applied 
to Delinquent Girls." Princeton, N. J., The Journal of 
Experimental Psychology, December, 1916. 

Biittner, Georg. — "Vom Wandertrieb bei den Kindern." Lan- 
gensalza, Zeitschrift fiir Kinder f or schung, April-Mai, 1915. 

Currier, Albert H — "The Present Day Problem of Crime." 
Boston, Richard G. Badger, 191 2. 

Fernald, Walter E., M.D.— "The Imbecile with Criminal In- 
stincts." American Journal of Insanity, April, 1909. 

Ferrero, Gina Lombroso. — "Criminal Man According to the 
Classification of Cesare Lombroso." New York, G. P. 
Putnam's Sons, 191 1. 

Folks, Homer. — "The Care of Destitute, Neglected, and Delin- 
quent Children." New York, The Macmillan Co., 1907. 

Goddard, Henry Herbert, Ph.D. — "The Criminal Imbecile." 
New York, The Macmillan Co., 191 5. 

Hart, Hastings H, LL.D. — "The Extinction of the Defective 
Delinquent." New York, Russell Sage Foundation, 1913. 

Healy, William, M.D. — "The Individual Delinquent." Boston, 
Little, Brown & Co., 1915. 

Hiatt, James S. — "The Truant Problem and the Parental 
School." Washington, U. S. Bureau of Education, Bul- 
letin, 1915, No. 29. 

Howard, William Lee, M.D. — "Why So Many Boys and Girls 
Can't Help Running Away." New York American, 
September 19, 1915. 

Irwin, Elizabeth A. — "Truancy." Published by the Public 
Education Association of the City of New York, June, 

1015- 
Johns, W. A. — "Agricultural Education for Delinquent Boys." 

Columbus, The Ohio Teacher, August, 191 5. 
Kelley, Truman Lee. — "Mental Aspects of Delinquency." 

Austin, Tex., University of Texas Bulletin, March 1, 191 7. 



734 BIBLIOGRAPHY 

London, Jack. — "The Star Rover." New York, The Macmillan 

Co., 1915. 
MacCurdy, Dr. John. — "Other Factors than Feeble-mindedness 

in Juvenile Delinquency." Proc. N. J. Conference of 

Charities and Correction, 1916. 
McConnell, Ray Madding, Ph.D. — "Criminal Responsibility 

and Social Constraint." New York, Charles Scribner's 

Sons, 1913. 
McDonald, Arthur. — "Abnormal Man." Bureau of Education, 

Circular of Information no. 4, 1893. 
"Principles of Criminal Anthropology." New York, 

Educational Foundations, January, 191 5. 
Par melee, Maurice, M.A. — "The Principles of Anthropology and 

Sociology in Their Relations to Criminal Procedure." 

New York, The Macmillan Co., 1908. 
SchojJ, Hannah Kent. — "The Wayward Child. A Study of the 

Causes of Crime." Indianapolis, The Bobbs-Merrill Co., 

1915- 
Swift, Edgar James. — "Some Criminal Tendencies of Boyhood." 

The Pedagogical Seminary, March, 1901. 
Weidensall, Jean, Ph.D. — "The Mentality of the Criminal 

Woman." Baltimore, Warwick and York. 
Wilker, Karl. — "Die jugendlichen Kriminellen, 1912." Langen- 

salza, Zcitschrift fur Kinder f or schung, September, 1914. 

XII. MORAL AND SEXUAL PROBLEMS 

Bartz, August. — " Kindliche Pornographen." Langensalza, Zeit- 

schrift fur Kinderf or schung, April-Mai, 1915. 
Bingham, Gen. Theodore A. — "The Girl That Disappears. 

The Real Facts About the White Slave Traffic." Boston, 

Richard G. Badger, 191 1. 
Brown II, Sanger, M.D. — "The Sex Worship and Symbolism 

of Primitive Races." Boston, Richard G. Badger, 1916. 
Ellis, Havelock. — "Man and Woman." London, England, The 

Walter Scott Publishing Co., Ltd.; New York, Charles 

Scribner's Sons, 1916. 
Forel, August, M.D., Ph.D.— "The Sexual Question." English 

adaptation from the second German edition, by C. F. 

Marshall, M.D., New York, Medical Art Agency. 



BIBLIOGRAPHY 735 

Hood, Mary G., M.D.— "For Girls and the Mothers of Girls." 

A Book for the Home and the School Concerning the 

Beginnings of Life. Indianapolis, The Bobbs-Merrill 

Co., 1914. 
Howard, Clifford. — " Sex Worship. An Exposition of the Phal- 
lic Origin of Religion." Chicago Medical Book Co., 1909. 
Kraft-Ebing, Dr. R. B. — " Psychopathia Sexualis." Stuttgart, 

Ferdinand Enke, 1894. 
Martin, F. G. — "Moral Training of the School Child." Boston, 

Richard G. Badger, 1913. 
Michels, Robert. — "Sexual Ethics." London, England, The 

Walter Scott Publishing Co., Ltd.; New York, Charles 

Scribner's Sons, 191 5. 
Moll, Dr. Albert.— "The Sexual Life of the Child." Translated 

from the German by Dr. Eden Paul. New York, The 

Macmillan Co., 1913. 
Robie, W. F., A.B., M.D.— "Rational Sex Ethics." Boston, 

Richard G. Badger, 1916. 
Scholtz, Moses, M.D. — "Sex Problems of Man in Health and 

Disease." Cincinnati, Stewart & Kidd Co., 1916. 
Schroeder, Theodore. — "Our Prudish Censorship Unveiled." 

San Francisco, Pacific Medical Journal, June, 1915. 
Willis, W. N— "The White Slaves of London." Boston, 

Richard G. Badger. 
Zenner, Philip, M.D. — "Education in Sexual Physiology and 

Hygiene." Cincinnati, The Robert Clarke Co., 1910. 

XIII. HEREDITY AND EUGENICS 

Cotton, Henry A., M.D. — "Some Problems in the Study of 
Heredity in Mental Diseases." Cold Spring Harbor, 
L. I., Eugenics Record Office, Bulletin no. 8. 

Danielson, Florence H., and Davenport, Charles B. — "The Hill 
Folk. Report on a Rural Community of Hereditary De- 
fectives." Cold Spring Harbor, L. I., Eugenics Record 
Office, Memoir no. 1, August, 191 2. 

Goddard, Dr. Henry Herbert.— "The Kallikak Family. A Study 
in the Heredity of Feeble-Mindedness." New York, The 
Macmillan Co., 191 2. 

Guyau, J. M. — "Education and Heredity." London, England, 



736 BIBLIOGRAPHY 

The Walter Scott Publishing Co., Ltd.; New York, 

Charles Scribner's Sons, 1909. 
Knopf, S. Adolphus, M.D.— "Birth Control— Its Medical, So- 
cial, Economic and Moral Aspects." New Ulm, Minn., 

Mind and Body, April, 191 7. 
Letourneau, Ch. — "The Evolution of Marriage." London, 

England, The Walter Scott Publishing Co., Ltd.; New 

York, Charles Scribner's Sons, 1914. 
Meyer, Adolf, M.D.— "The Right to Marry." The Survey, 

June, 1916. 
C? Gorman, Dr. M. W. — "Infant Mortality, as Affected by Men- 
tal Deficiency in the Mother." Proc. N. J. Conference 

of Charities and Correction, 1916. 
Orschansky, Dr. J. — "Die Vererbung im gesunden und kranken 

Zustande." Stuttgart, Ferdinand Enke, 1903. 
Stevens, Margaret. — "Woman and Marriage." New York, 

Frederick A. Stokes Co., 1910. 
Stokes, W. E. D. (Lexington, Ky.)— "The Right to be Well 

Born, or Horse Breeding in Its Relation to Eugenics." 

Printed by C. J. O'Brien, New York, 1917. 
Walter, Herbert Eugene. — " Genetics. An Introduction to the 

Study of Heredity." New York, The Macmillan Co., 

1914. 
Watson, J. A. S., B.Sc. — "Heredity." London, Toronto, New 

York, Dodge Publishing Co., "The People's Books" 

Series. 
Weismann, August. — "The Germ-Plasm." London, England, 

The Walter Scott Publishing Co., Ltd.; New York, 

Charles Scribner's Sons, 1915. 

XIV. HOME PROBLEMS 

Birney, Mrs. Theodore W. — "Childhood." New York, Fred. 

A. Stokes Co., 1905. 
Bosanquet, Helen. — "The Family." London, Macmillan & Co., 

Limited, 1915. 
Chance, Maria B.— "Self-Training for Mothers." Philadelphia, 

J. B. Lippincott Co., 1914. 
Eastman, Elaine Goodale. — "The Waste of Life." New York, 

The Popular Science Monthly, August, 191 5. 



BIBLIOGRAPHY 737 

Eghian, Setrak G., M.D.— "The Mother's Nursery Guide." 
New York, G. P. Putnam's Sons, 1907. 

Harland, Marion. — "Common Sense in the Nursery." New 
York, Charles Scribner's Sons, 1885. 

Holden, Horace. — "Young Boys and Boarding School." Boston, 
Richard G. Badger, 1913. 

Holt, L. Emmett. M.D.— "The Care and Feeding of Chil- 
dren." New York and London, D. Appleton & Co., 

I9I3- 

Kerley, Charles Gilmore, M.D.— "Short Talks with Young 
Mothers." New York, G. P. Putnam's Sons, 1909. 

King, F. Truby. M.B., B.Sc— "Feeding and Care of Baby." 
London, Macmillan & Co., Ltd., 1913. 

Lehmann, Rudolf. — "Erziehung und Erzieher." Berlin, Weid- 
mannsche Buchhandlung, 1901. 

McKeever, William A. — " Training of the Boy." The Macmillan 
Co., 1913. 

"Training the Girl." Same publisher, 1914. 

Oppel, Dr. Karl.— "Das Buch der Eltern." Frankfurt a. M., 
Moritz Diesterweg, 1896. ~~J 

Read, Mary L., B. S. — "The Mothercraft Manual." Boston, 
Little, Brown & Co., 1916. ^____ — 

Richardson, Anna Steese. — "Better Babies and Their Care." 
New York, Fred. A. Stokes Co., 1914. 

Sloner, Winifred Sackville. — "The Manual of Natural Educa- 
tion." The Bobbs-Merrill Co., Indianapolis, 1916. 

Twedell, Francis, M.D.— "A Mother's Guide." New York, 
James T. Dougherty, 191 1. 



XV. SOCIAL AND RACIAL PROBLEMS 

Abbott, Grace. — "The Immigrant and the Community." New 
York, The Century Co., 191 7. 

Allen, William H. — "Civics and Health." Boston, Ginn & Co., 
1909. 

Baldwin, James Mark, Ph.D. — "Social and Ethical Interpreta- 
tions in Mental Development. A Study in Social Psy- 
chology." New York, The Macmillan Co., 1913. 

Blascoer, Frances. — "Colored School Children in New York." 
Public Education Association in New York, 1915. 



738 BIBLIOGRAPHY 

Byers, Joseph P. — "The State as a Delinquent Parent." Vine- 
land, N. J., The Training School Bulletin, February, 1916. 

Cooley, Charles Horton. — "Human Nature and the Social Order." 
New York, Charles Scribner's Sons, 1902. 

"Social Organization." New York, Charles Scribner's 

Sons, 1916. 

Deniker, J., Sc.D. — "The Races of Man." London, England, 
The Walter Scott Publishing Co., Ltd.; New York, 
Charles Scribner's Sons. New edition. 

Eliot, Charles W. — "The Conflict Between Individualism and 
Collectivism in a Democracy." New York, Charles 
Scribner's Sons, 191 2. 

Ellwood, Chas. A., Ph.D.— "The Social Problem. A Construc- 
tive Analysis." New York, The Macmillan Co., 1915. 

Engel, Dr. Sigmund. — "The Elements of Child-Protection." 
Translated from the German by Dr. Eden Paul. New 
York, The Macmillan Co., 191 2. 

"Haiti — the Land of the Black Man's Burden." New York, 
The World Magazine, August 22, 191 5. 

Henderson, Charles Richmond. — " Social Elements." New York, 
Charles Scribner's Sons, 1898. 

Keller, Albert Galloway. — "Societal Evolution." New York, 
The Macmillan Co., 1915. 

Lafargue, Paul. — "The Evolution of Property." London, Eng- 
land, Swan Sonnenschein & Co., Ltd.; New York, Charles 
Scribner's Sons, 1905. 

Letourneau, Ch. — "Property: Its Origin and Development." 
London, England, The Walter Scott Publishing Co., Ltd.; 
New York, Charles Scribner's Sons, 1914. 

Mayo, Marion J. — "The Mental Capacity of the American 
Negro." New York, The Science Press, November, 1913. 

N earing, Scott, Ph.D. — "Poverty and Riches. A Study of the 
Industrial Regime." Philadelphia, The John C. Winston 
Co., 1916. 

Odum, Howard W. — "Negro Children in the Public Schools of 
Philadelphia." Philadelphia, Annals of the American 
Academy of Political and Social Science, September, 1913. 

Reclus, Elie. — "Primitive Folk." London, England, The Walter 
Scott Publishing Co., Ltd.; New York, Charles Scribner's 
Sons. New edition. 



BIBLIOGRAPHY 739 

Riis, Jacob A. — "How the Other Half Lives." New York, 
Charles Scribner's Sons, 1914. 

"The Children of the Poor." New York, Charles Scrib- 
ner's Sons, 1915. 

Sharp, George. — "City Life and Its Amelioration." Boston, 
Richard G. Badger, 191 5. 

Cf. also the Philippine Publications of the World Book 
Co., Yonkers, N. Y. 

XVI. LEGAL ASPECTS 

Hood, William R., Weeks, Stephen B., and Ford, A. Sidney. — 
"Digest of State Laws Relating to Public Education," 
in Force January 1, 191 5. Washington, U. S. Bureau of 
Education, Bulletin, 1915, no. 47. 

U. S. Bureau of Education. — "Compulsory School Attendance." 
Bulletin, 1914, no. 2. 

XVII. SCHOOL PROBLEMS 

Bachman, F. P. — "Problems in Elementary School Administra- 
tion." Yonkers, World Publishing Co., 1915. 

Bagley, William Chandler. — "School Discipline." New York, 
The Macmillan Co., 1915. 

and Coffman, Lotus D. — "Differentiated Curriculum vs. 

Common Elements." National Education Association 
Proceedings, February 24, 1916. 

Ballou, F. W— " High School Organization." World Publishing 
Co., 1915. 

Bunker, Frank Forest. — "Re-organization of the Public School 
System." Washington, U. S. Bureau of Education, 
Bulletin, 1916, no. 8. 

Campbell, C. Macfie, Ph.D.— "The Subnormal Child— A Study 
of the Children in a Baltimore School District." Con- 
cord, N. H., Mental Hygiene, January, 1917. 

Cornell, W. Burgess, M.D. — "Mental Deficiency in the Schools." 
Proc. N. J. Conference of Charities and Correction, 1916. 

Courtis, S. A. — "Standards in Arithmetic." World Publishing 
Co., 1915. 

Cubberley, E. P., et al — "The Portland Survey." World Pub- 
lishing Co., 1915. 



740 BIBLIOGRAPHY 

Davis, C. O— "High School Courses of Study." World Pub- 
lishing Co., 1915. 
Dayton, Roy. — "Our Futile Public Schools." New York, Pear- 
son's Magazine, October, 1914. 
Elliott, E. C. — "City School Administration: A Constructive 

Study." World Publishing Co., 1915. 
Gayley, Prof. Charles Mills. — "Idols of Education." New York, 

Doubleday, Page & Co., 1910. 
Groszmann, Maximilian P. E , Pd.D. — "The Common School and 

the New Education." Syracuse, N. Y., C. W. Bardeen, 

1897. 
"The Career of the Child from the Kindergarten 

to the High School." Boston, Richard G. Badger, 

1911. 
"Some Fundamental Verities in Education." Boston, R. 

G. Badger, 1911. 
Hanus, Prof. Paul H. — "School Efficiency: A Constructive 

Study." World Publishing Co., 1915. 
Hollisler, Horace A. — "The Administration of Education in 

a Democracy." Chas. Scribner's Sons, New York, 

1914. 
McMurry, F. M. — "Elementary School Standards: Instruction, 

Course of Study, Supervision." World Publishing Co., 

Moore, E. C. — "How New York City Administers Its Schools: 
A Constructive Study." World Publishing Co., 1915. 

XVIII. VOCATIONAL PROBLEMS 

Barnard, John. — " Every Man His Own Mechanic." New York, 

Frederick A. Stokes Co., 191 2. 
Bruce, H. Addington. — "A Vocational School a Hundred Years 

Old." New York, The Outlook, July 28, 1915. 
Eaton, Jeanette, and Stevens, Bertha M. — "Commercial Work 

and Training for Girls." New York, The Macmillan Co., 

I9i5- 

"Effects of Employment on Children." Medical Times, De- 
cember, 1916. 

Horspool, Florence. — "Mothercraft for School Girls." Lon- 
don, Macmillan & Co., 1914. 



BIBLIOGRAPHY 741 

Kerschensteiner , Georg. — "The Idea of the Industrial School." 
Translated from the German by Rudolf Pintner, Ph.D., 
New York, The Macmillan Co., 1913. 

McKeever, William. — "Farm Boys and Girls." New York, The 
Macmillan Co., 1913. 

"The Industrial Training of the Boy." Same publisher, 

1914. 

"The Industrial Training of the Girl." Same publisher, 

1914. 

Schneider, H. — "Education for Industrial Workers." Yonkers, 
N. Y., World Publishing Co., 191 5. 

Taylor, Joseph S., Pd.D. — "A Handbook of Vocational Educa- 
tion." New York, The Macmillan Co., 1914. 

Thompson, F. V. — "Commercial Education in Public Secondary 
Schools." World Publishing Co., 1915. 

Weeks, Ruth Mary. — "The People's School. A Study in Voca- 
tional Training." Boston, The Houghton Mifflin Co., 
1912. 

XIX. PROBLEMS OF METHOD 

Bailey, Carolyn Sherwin. — "Girls' Make-at-Home Things." 

New York, Frederick A. Stokes Co., 191 2. 
and Bailey, Marian Elizabeth. — "Boys' Make-at-Home 

Things." Same publisher, 191 2. 
Bancroft, Jessie H. — "Games for the Playground, Home, School 

and Gymnasium." New York, The Macmillan Co., 1915. 
Beard, Patten.— "The Jolly Book of Boxcraft." New York, 

Frederick A. Stokes Co. 
Brown, Elmer E. — "Notes on Children's Drawings." Univer- 
sity of California Studies, 1895. 
Canfield, Dorothy.— " What Shall We Do Now? A Book of 

Suggestions for Children's Games and Employments." 

New York, Fred. A. Stokes Co., 1907. 
Cook, W. A., and O'Shea, M. V.— "The Child and His Spelling." 

Indianapolis, The Bobbs-Merrill Co., 1914. 
Curtis, Henry S— "Education Thru Play." New York, The 

Macmillan Co., 191 5. 
Dodd, Catherine I. — "Introduction to the Herbartian Principles 

of Teaching." New York, The Macmillan Co., 1906. 



742 BIBLIOGRAPHY 

Ebert, Marie.— "The Weaver's Shuttle. A World Out of Noth- 
ing." Newark, N. J., The E. E. Morris Printing Co., 
1914. 

Ealleck, Reuben Post. — "The Education of the Central Nervous 
System: A Study of Foundations, Especially of Sensory 
and Motor Training." New York, The Macmillan Co., 

IQIO. 

Eillyer, V. M., A.B. — "Kindergarten at Home: A Kindergarten 
Course for the Individual Child at Home." New York, 
Doubleday, Page & Co., 191 2. 

Jones, Olive M., Leary, Eleanor G., and Quish, Agnes E. — 
"Teaching Children to Study. The Group System Ap- 
plied." The Macmillan Co., 1910. 

King, Irving. — "The High School Age." Indianapolis, The 
Bobbs-Merrill Co., 1914. 

Kinne, Helen, and Cooley, Anna M. — "Foods and the Household 
Management." The Macmillan Co., 1914. 

"Shelter and Clothing." Same publisher, 1914. 

Legge, J. G. — "The Thinking Hand; or, Practical Education in 
the Elementary School." The Macmillan Co., 1914. 

McLcllan, James A., and Dewey, John, Ph.D. — "The Psychology 
of Number and Its Applications to Methods of Teaching 
Arithmetic." New York, D. Appleton & Co., 1895. 

McMurry, Charles A., Ph.D. — "Course of Study in the Eight 
Grades." The Macmillan Co., 1906. 

Montessori, Maria. — "The Montessori Method." Translated 
from the Italian by Anne E. George. New York, Fred- 
erick A. Stokes Co., 191 2. 

"Dr. Montessori's Own Handbook." Same publisher, 1914. 

Parsons, Belle Ragnar. — "Plays and Games for Indoors and Out. 
Rhythmic Activities Correlated with the Studies of the 
School Program." New York, A. S. Barnes & Co., 1909. 

Smith, Nora Archibald. — "The Kindergarten in a Nutshell." 
New York, Doubleday, Page & Co., 1907. 

Stevens, Ellen Yale.— "A Guide to the Montessori Method." 
New York, Fred. A. Stokes Co., 1913. 

Swift, Prof. Edgar James. — "Learning and Doing." Indianap- 
olis, The Bobbs-Merrill Co., 1914. 

"The Boston Way: Plans for the Development of the Indi- 
vidual Child." Compiled by the Special Class Teachers 



BIBLIOGRAPHY 743 

of Boston. Boston, Mary C. Culhane, Somerset Street 
School, 1917. 

V andewalker , Nina C. — "The Kindergarten in American Edu- 
cation." The Macmillan Co., 1908. 

Ward, Florence Elizabeth. — "The Montessori Method and the 
American School." The Macmillan Co., 1913. 

XX. SPECIAL SCHOOL PROVISIONS 

Boston Public Schools. — "Syllabus for Special Classes." Sep- 
tember, 1914. School Document no. 4. 

Farrell, Elizabeth E. — "A Study of the School Inquiry Report 
on Ungraded Classes." Philadelphia, The Psychological 
Clinic, vol. VIII, nos. 3 and 4. 

Fitts, Ada M. — "How to Fill the Gap Between the Special 
Classes and Institutions." Journal of Psycho- A sthenics, 
March and June, 1916. 

Goddard, Henry H. — "School Training of Defective Children." 
School Efficiency Series. World Book Co., Yonkers, 
N. Y., 1915. 

Hetherington, Clark W. — "The Demonstration Play School of 
1913." Berkeley, University of California Publications. 
Education, V, 2. 

Holmes, William H., Ph.D. — "School Organization and the Indi- 
vidual Child." Worcester, Mass., The Davis Press, 191 2. 

MacMurchy, Helen, M.D. — "Organization and Management of 
Auxiliary Classes." Toronto, Ont., Educational Pam- 
phlet no. 7, Dept. of Education. 

Maennel, Dr. B. — "Auxiliary Education: the Training of Back- 
ward Children." Translated from the German by Emma 
Sylvester, Pd.M. New York, Doubleday, Page & Co., 
1909. 

Mitchell, David. — "Schools and Classes for Exceptional Chil- 
dren." Cleveland Education Survey, The Cleveland 
Foundation, Cleveland, O., 1916. 

Naville, Dr. F. — "Quatre Annees d'lnspection Medicale des 
Classes Speciales de Geneve." Geneva, Switzerland, 
Imprimerie Atar, 1914. 

"Reglement et Programme des Classes Speciales pour Enfants 
Arrieres." Geneva, Imprimerie du Commerce, 191 1. 



744 BIBLIOGRAPHY 

Rolhe, Karl Cornelius. — " Sonder-Elementarklassen fur sprach- 
kranke Kinder." Munchen, Fr. Seyboldt, 1914. 

Van Sickle, James H., Witmer, Lightner, and Ayers, Leonard 
P. — "Provisions for Exceptional Children in Public 
Schools." Washington, U. S. Bureau of Education, 
Bulletin, 191 1, No. 14. 

XXL UNCLASSIFIED 

Baldwin, James Mark, Ph.D. — "Mental Development in the 
Child and the Race." New York, The Macmillan Co., 

1895- 

Bells, George Herbert, Ph.D. — "Social Principles of Education." 
New York, Chas. Scribner's Sons, 191 2. 

Blue, Rupert (Surgeon-General). — "Mental Examinations of 
School Children. The School as a Factor in the Mental 
Hygiene of Rural Communities." U. S. Public Health 
Report no. 358, August 25, 1916. 

Bolton, Frederick Elmer, Ph.D. — "Principles of Education." 
New York, Chas. Scribner's Sons, 19 10. 

Boone, Richard G., Ph.D. — " Science of Education." New York, 
Chas. Scribner's Sons, 1904. 

Colegrove, Chauncey P., A.M., Sc.D. — "The Teacher and the 
School." New York, Chas. Scribner's Sons, 1910. 

Dannemann, Schober, Schulze. — " Enzyklopadisches Handbuch 
der Heilpadagogik." Halle, Carl Marhold, 191 1. 

Goodhart, S. Philip, M.D. — "The Exceptional Child; the In- 
fluence of Environment and Education Upon His Devel- 
opment." Proceedings, National Education Association, 
Boston, 1910. 

Groszmann, Maximilian, P. E., Pd.D. — "A Working System of 
Child Study for Schools." Syracuse, C. W. Bardeen, 
1897. 

Hall, G. Stanley, Ph.D. — "Adolescence: Its Psychology and Its 
Relations to Physiology, Anthropology, Sociology, Sex, 
Crime, Religion, and Education." New York, D. Apple- 
ton & Co., 1904. 

Herbarl, John Friedrich. — "Outlines of Educational Doctrine." 
Translated from the German by Alexis F. Lange, Ph.D., 
The Macmillan Co., 1913. 



BIBLIOGRAPHY 745 

Holmes, Arthur, Ph.D. — "Principles of Character Making." 

Philadelphia, J. B. Lippincott Co., 1913. 
Mangold, George B., Ph.D. — "Problems of Child Welfare." 

The Macmillan Co., 1914. 
McKeever, Wm. A. — "Outlines of Child Study: A Text Book for 

Parent-Teachers Associations, Mothers' Clubs, and all 

Kindred Organizations." The Macmillan Co., 1915. 
National Association for the Study and Education of Exceptional 

Children. — "Proceedings, 1910 and 191 1." Plainfield, 

N.J. 
National Conference on the Education of Backward, Truant, and 

Delinquent Children. — "Proceedings, 1906 and 1907." 

O. E. Darnell, Sec'y, Washington, D. C. 
Oppenheim, Nathan, M.D. — "The Development of the Child." 

The Macmillan Co., 1913. 
O'Shea, M. V. — "Dynamic Factors in Education." The Mac- 
millan Co., 1909. 
Seguin, Edward. — "Report on Education." Milwaukee, 1880. 
Shearer, William J., Pd.D. — "The Management and Training of 

Children." New York, Richardson, Smith & Co., 1904. 
Shule, Henry A. — "The Real Diary of a Real Boy." Boston, 

The Everett Press Co., 1909. 
Smith, William Hawley— "All the Children of All the People." 

The Macmillan Co., 1914. 
Stoner, Winifred Sackville. — "Natural Education." Indianap- 
olis, The Bobbs-Merrill Co., 1914. 
Talbot, Eugene S., M.D., D.D.S. — "Degeneracy." London, 

England, The Walter Scott Publishing Co., Ltd.; New 

York, Charles Scribner's Sons. 
Taylor, J. Madison, M.D.— "Difficult Boys." New York, The 

Popular Science Monthly, October, 1906. 
"The Uplift Book of Child Culture." Uplift Publishing Co., 

Philadelphia. 
Thorndike, Edward L. — "Education. A First Book." The 

Macmillan Co., 191 2. 
Warner, Francis, M.D.— "The Study of Children and Their 

School Training." The Macmillan Co., 1915. 
Weimer, Dr. Herman.— "The Way to the Heart of the Pupil." 

Translated from the German by J. Remsen Bishop. The 

Macmillan Co., 1913. 



746 BIBLIOGRAPHY 

Welton, J., D.Litt., M.A.— " What Do We Mean by Education?" 
London, Macmillan & Co., Ltd.; 1914. 

Wlnterburn, Florence Hull. — "From the Child's Standpoint. 
Views of Child Life and Nature." New York, The Baker 
& Taylor Co. (Doubleday, Page & Co.), 1899. 



INDEX 



A's, ioo, p. 323. 

Abacus, 338. 

Aberrations, 430. 

Abnormal children, 8, 13, 15, 63, 67, 

70, 72, 77, 142, 374, 430, 496/., 577- 
Abnormalities of growth, 99, 579. 
Abortion, 410/. 
Absent-mindedness, 104. 
Abstract thought, 15. 
Abstract work, 149. 
Acceleration, 65, 107. 
Accidents, 62. 

Accuracy, standards of, 519. 
Acid test, 170. 
Acquired conditions, 592. 
Acromegaly, 640. 
Action, 487, 490. 
Activities (tests), 332. 
Adding game, 339. 
Adenoids, 61, 482, 581, 586 Jf., 621, 

679, 688. 
Adjustment, 58, 509, 547. 
Adolescence, 137, 198, 200, 207, 217, 

429, 556, 649, 681, 685. 
Adrenals, 632 jf., 657. 
Adults, 40, 82, 180, 611. 
Advanced period, 42. 
Adventuresomeness, 55. 
/^Esthetic attitude, 359 Jf. 
Affection, 641. 
Age (school), 389/. 
Agenetic type, 572. 
Agraphia, 103, 126, 144, 149, 256. 
Agriculture, 21. 
Ainus, 171. 
Air, 652. 
Alaska, 360 Jf. 
Alcohol (alcoholism), 152, 204, 227, 

580, 635, 641, 677. 
Alexia, 103, 126, 144, 149, 256. 
Alignment (teeth), 585. 
Altruism, 693 Jf. 
Ambleside, 417. 
Amblyopia, 618. 
Amentia, 140, 161, 163. 
America, 481. 

American Academy of Medicine, 60. 
American type, 2, 57, 171/., 176. 
composite stock, 30, 50. 
international in essence, 2. 
Amusement, 211. 



Anasmia, 101, 103, 580, 581. 
Anaemic children, 501. 
Anatomical growth, 99. 

anatomical age, 99, 285. ' 
anatomical conditions, 144. 
Anatomical tests, 235. 
Anatomy of f eeble-mindedness, 698 Jf. 
Anchor puzzles, 354. 
Angelo, Michael, 119, 127. 
Anomaly of character, 694. 
Anthropometric data, 234. 
Anxiety, 580, 672. 
Aphasia, 144, 149. 
Appendicitis, 635. 
Apperceptive basis, 324, 509, 536. 
apperceptive ability, 352, 536. 
Appetite, 100, 654. 
Aptitudes, 441, 460, 484. 
Arithmetic, 149, 340/-. 44°, 45 1 . 5 2 7, 

530. 
Arnold, Dr. E. H., 592, 704. 
Arrest of development, 8, 51, 62, 84, 

140, 162 Jf., 201. 
Art expression, 359 Jf. 
art studies, 377. 
art work. 516 Jf. 
Articulation, 100, 512/., 602. 
Articulo-respiratory centre, 603. 
Artistic type, 15, 58, 118, 127, 484. 
Asceticism, 673. 
Asiatic mind, 193. 
Assimilation, 580. 
Association, 316, 646, 676. 
Associational fibres, 577. 
Asthenic, 632. 
Asthma, 633. 
Astigmatism, 103. 
Atavistic types, 48, 63. 
Ataxias, 639. 
Athletic games, 554 /. 
Attendance, irregular, 482. 
Attendance officers, 212, 494. 
Attention. 132, 154, 318, 487, 490, 

581, 657 J- 
Attitudes, 460. 
Atypical children, 8, 61, 71, 97, 151, 

485. 490, 504/-, S83, 596J r ., 629/., 

684. 
Auditory sense, 611. 

auditory areas, 621. 
Auditory tests, 304 Jf. 



747 



748 



INDEX 



Aural memory, 150, 306 Jf. 

Ausgedinge, 201. 

Austria, 481. 

Automatism, 135. 

Auxiliary classes, 166. 

Average children, 16, 70, 72, 369. 

average character, 73. 

average normality, 81. 
Awakening in alarm, 153. 

Bacchus, 222. 

Backwardness, 16, 48, 51, 56, 81, 137, 
386, 391, 481/., 580, 639 Jf-, 722. 
backward races, 54. 
backward types, 56. 

Balance, 72, 87, 97, 154. 
sense of balance, 316. 

Balkan 'states, 54. 

Ballou, Dr. Frank W., 273, 341 Jf. 

Balzac, Honore, 92. 

Barbarism, 201. 

Bard, Sarah, 677. 

Bardeen, Dr. C. B., 397. 

Barefoot Boy, 206, 440, 487. 

Barry, John D., 202. 

Barry, Richard, 45. 

Basedow's disease, 632, 640. 

Baths, 627, 629, 655/. 

Beecher, Henry Ward, 92. 

Beethoven, 127. 

Beggars, 173. 

Bell, Prof. J. C, 265. 

Benefit of the doubt, 179. 

Berlin, 418. 

Betting, 192. 

Bibliography, 7 1( )Jf- 

Big Brother and Big Sister Move- 
ment, 553. 

Binet (Simon) Tests, 68, 73, 8o/., 150, 
162, 165 Jf., 170 if., 196, 232, 240, 
253 Jf-. 320, 330, 347, 700 Jf. 

Biological laws and causes, 35, 40, 519. 

Birth, 571. 

conditions of birth, 280/. 
regulation of births, 410. 
birth, instrumental, 640. 

Bisch, Dr. Louis E., 157. 

Black Hand, 45, 193. 

Bleuler, Dr. E., 649. 

Blindness, 8, 62, 66, 70, 97, 296, 382, 
386, 501/., 597, 618 Jf., 640. 

Blood conditions, 580, 636. 

Blood tests, 701. 

Blue Laws, 47. 

Body, 87, 99. 

body measurements, 233 /. 

Bone conditions, 636. 



Book study, 440, 455. 

Boor, 49. 

Borderland cases, 6g. 

Born short, 58. 

Boston, 341 Jf., 490, 580. 

Bottle-feeding, 584 Jf. 

Bourneville, Dr., 701. 

Boy Scouts, 549 Jf. 

Boys, 41, 82 Jf., 203, 220 Jf., 439, 

549 Jf., 682, 690/. 
Brain, 125/., 135, 440, 571 Jf., 576 Jf., 
582, 599, 618. 

unused brain cells, 20, 134. 

brain centres, 54, 102, 103, 601 Jf., 
6i8Jf., 701. 

retarded brain development, 62, 
104. 

brain mechanism, 123. 

brain defects, 639 Jf. 

brain of the feeble-minded, etc., 
699/. 
Breast-feeding, 584 Jf. 
Breasts, 632. 
Breathing, 512 /., 578, 586, 599 Jf., 

609, 655. 
Bridgman, Laura, 97, 703. 
Bright children, 8, 15, 16, 106 Jf., 461. 
Bronner, Augusta, 196. 
Browning, Dr. Wm., 148. 
Buccaneers, 49. 
Budding time, 132, 209, 373. 
Buffalo, 195. 
Building, 356. 

Burke, Dr. W. F. Blake-, 684, 704. 
Burlesque shows, 558. 
Burns, Robert, 92. 
Business of life, 4 /. 
By-products, 6, 388. 

Calcium metabolism, 632. 

Calculating immoral, 694 jf. 

Caldwell, Armour, 5. 

Camorra, 45, 199. 

Campbell, Alfred W., 701. 

Camps, 378. 

Cancer, 635. 

Captains of industry, 24, 30. 

Caries, 585. 

Carpal bones, 235/., 636. 

Carrigan, Rose A., 340. 

Carter, R. B., 452. 

Carus, Dr. Paul, 124, 440. 

Castes, 22. 

Categorical imperative, 547. 

Categories (tests), 333. 

Catholic University, 452. 

Caucasians, 171 /. 



INDEX 



749 



Census, 494. 

Centres of industry, etc., 26. 

Cerebral defects, 572, 640. 

Cerebral palsy, 680. 

Cerebrospinal meningitis, 640. 

Certificates of employment, 495. 

Certificates of scholarship, 450. 

Change of schools, 61, 90, 482. 

Character, 186, 658, 693. 

Charity, 6, 49, 50, 94, 378, 384 /., 

470 /• 
Chest measurements, 580. 
Chicago, 580. 
Chicago stock yards, 164. 
Child History, 232, 233, 277 Jf., 

5<H #• 
Child hygiene, 427, 723 Jf. 
Child labor, 191, 389, 422, 493 Jf. 
Child study, 269. 
Child welfare dept., 550. 
Childhood, 438, 572, 632. 

childhood, diseases of, 680. 
Children, 40, 82, 89, 165, 180, 200, 

201, 202, 207, 219, 225, 410 Jf., 416, 

422, 427 Jf., 457 Jf., 489, 535 Jf., 

549/., 568, 611, 631/. 
Children's Courts, 385, 549 Jf., 692. 
Children's stipends, 392. 
China (Chinese), 45, 54, 188, 193. 
Chlorosis, 635. 

Chorea, 101, 104, 137, 581, 639. 
Chrisman, O., 329. 
Chronological age, 99, 285, 389 Jf. 
Church, 556. 

Church and Peterson, 135. 
Cigarettes, 204, 688. 
Ciphers, 329 jf. 
Circulation, 154. 
Circumcision, 690. 
Circumspection, 87. 
Circumstances, 66. 
Circumstantial evidence, 232. 
City, 549 Jf. 
Civic Service, 58. 
Civilization, 36, 47, 137, 172, 175. 

177 /., 186 /., 222, 325, 359, 388, 

425, 440, 513, 516, 545. 
Civilization levels, 35 Jf., 58, 69, 93, 

171, 173, 192, 222, 256, 325, 459. 
Classification, 60 Jf., 232, 539, 562, 

592, 719. 
industrial classification, 166. 
limitations, 63. 
tests, 332. 
Clay modelling, 516. 
Cleanliness, 47. 
Clinical studies, 150, 162, 180, 268 Jf. 



Clinics, 

dental clinic, 479. 

educational clinic, 113, 157, 212, 
268/., 277, 375, 475, 479. 

medical clinic, 212, 272 Jf., 475, 
479- 

orthopedic clinic, 479. 

psychological clinic, 212, 269 Jf., 
479- 

psychopathic clinic, 157, 212, 
271/., 479. 

speech clinic, 609. 
Clothing, 580, 631, 655. 
Clubs (boys'), 555 Jf. 
Co-efficient of growth, 580. 

co-efficient of vital capacity, 580. 
Cohn, Prof. Herrmann, 298. 
Collection of data, 401. 
Collier, John, 550/. 
Colliver, Dr. J. A., 687, 704. 
Colonies for epileptics, 199. 
Color, 237, 257, 512. 

color blind, 237, 257, 300. 

color cubes, 354. 

color tests, 300. 
Colored school children, 51, 171, 

380. 
Combination, individual, 489. 
Comfort stations, 219. 
Commercial organizer, 15. 
Commercialized recreation, 555 Jf. 
Commission of experts, 232. 
Common, 213, 222. 
Common branches, 443. 
Common sense, 82, 180, 183, 266/. 
Communication, means of, 22. 
Community, 186, 421. 

community demands, 40. 

community efficiency, 25, 67. 

community problems, 5, 549 Jf. 
Companions, 210. 
Competency, 19 Jf., 34, 39, 42 /., 82, 

87, 489- 
Completion test, 327 Jf. 
Composite American stock, 30, 50. 
Composition (test), 335. 
Compulsory education, 212, 380 Jf., 

401 > 493- 

Computation of results, 259 Jf. 

Computing, 132. 

Concentration, 61, 102, 154, 321 Jf., 
487, 577, 582, 663. 

Conception (in utero), 571. 

Concepts, conception, 134. 

Concomitant factors of backward- 
ness, 639. 

Conditioning, 676. 



750 



INDEX 



Conduct, 39, 40/., 47, 209, 647. 

methodical, 69. 

primitive, 54. 
Confidence, 490. 
Conflicts, 165. 
Conformists, 80, 86, 460. 
Congenital conditions, 58, 61 Jf., 69, 

140, 153, 163/., 231/., 571, 592. 
Congestion, urban, 10. 
Conquered tribes, 50. 
Consanguinity, 644. 
Conscientiousness, 673. 
Conscious (consciousness), 133, 135, 

142, 201, 488, 646. 
Conservation, 17. 

Constipation, 590 J"., 632, 655, 686. 
Constitutional immoral, 693 jf. 
Constitutional inferiority, 635. 
Constitutional liars, 208. 
Construction (test), 349 Jf., 356 Jf. 
Constructive type, 15. 
Contagious diseases, 581. 
Contemporary ancestors, 50. 
Contents of children's minds, 324. 
Contractures, 593 Jf. 
Contrariness, 61. 
Conventional standards, 228. 
Conventional symbolism, 461. 
Convulsions, 100, 639/., 680. 
Co-operation, 546. 
Co-ordination, 519 jf. 
Copying (test), 335. 
Corpus luteum, 632. 

corpus callosum, 703. 
Correction, 6, 385. 
Cortex, 135, 577. 
Cost of protection, 6. 

cost of education, 6. 

cost of maintenance, etc., 497 Jf. 
Counting, 132, 149, 337 jf. 

counting period, 337. 
Country children, 568. 
Course of study, 376/., 444, 484, 501, 

506/., 510 if., 539, 575- 
Courtis, S. A., 341. 

Courtis tests, 340 Jf. 
Courts, 6. 
Courtships, 219. 
Crampton, Dr. C. Ward, 99, 235 /., 

590. 704- 
Cranks, 9, 67, 122. 
Crawford, Nina L., 378. 
Creation, 217. 
Creative force, 87. 
Creative methods, 509. 
Cretins, 63, 632, 639. 
Crile, Dr. Geo. W., 45- 



Crime (criminals, criminality), 9, 14, 
48, 56, 123, 142, 152, 160, 168, 173, 
185 Jf., 193, 199, 217, 384, 391, 401, 
495/-, 550 Jf-, 687 Jf., 694 Jf., 733/. 

Crippled children, 8, 62, 66, 381, 386, 
5oi, 597- 

Crises in development, 428. 

Crooks, 123, 404. 

Crowding of pupils, 11. 

Cruelty, 188, 201/. 

Cube puzzle, 353. 

Cultural efficiency, 88. 

Cultural scale, 58. 

Culture epochs, 40 Jf., 65, 83, 167, 249, 
359 Jf-, 468, 489, 518. 

Cure, 576. 

Curriculum, cf. Course of study. 

Custodial care, 14, 72, 177, 212, 377, 
398, 482, 498 Jf. 

Daily life, 506. 

daily routine, 628. 
Dance halls, 558 Jf. 
Danger-signals, 97, 99/., 430. 
Danielson, Dr. Florence H., 399. 
Darenth Industrial Colony, 499. 
Darwin, Charles, 92. 
Davenport, Prof. C. B., 159, 399. 
Davis, Philip, 552. 

Deafness (deaf children), 8, 62, 70, 
97 /.. 257, 305, 381 Jf., 501 /., 597, 
608 Jf.. 621, 640. 
Debiles, 70. 
Defecation, 591. 
Defectives, 381 Jf., 386. 

mental defectives, 13, 14, 36, 40, 

67, 98, 140, 207, 576. 
physical defectives, 40. 
Defects, physical, 567 Jf., 582, 722/. 
functional, 100, 572 Jf. 
mental, 140, 161, 481, 567 Jf., 
572 Jf- 
Deffenbaugh, W. S., 491 Jf. 
Deficiency scale, 78. 
Definitions, 510. 
Deformity, 9, 61, 62, 386, 482, 572, 

592 Jf- 
Degenerates (degeneracy), 36 /., 50, 

208, 372, 635, 697. 
Delinquency (delinquents), 48, 119, 
171, 185/., 236, 384/- 479/-, 
491 Jf., 549 Jf., 687 Jf., 733/. 
psychopathic delinquency, 142. 
delinquency and feeble-minded- 
ness, 193. 
Delinquent girls, 256. 
Dementia, 140, 161. 



INDEX 



751 



Dementia praecox, 151, 639, 648 jf. 
Dementia senilis, 226. 
Democracy, 176. 

democracy in education, 1 . 

democracy and efficiency, 29, 31. 

democracy and civilization levels, 
56/., 176. 
Demoor size-weight illusion, 349. 
Dental clinics, 479. 
Dental defects, 568, 581, 632, 636. 
Dentition, 680. 

Dependent children, 479, 493. 
Depressive mania, 152. 
Derailment, 72, 209. 
Derelicts, 9, 186. 
Destructiveness, 104. 
Detention home, 241, 479. 
Deterioration, 37. 
Developmental disturbances, 142, 162 

/., 482, 571 jr., 635. 

Developmental stages (periods), 40 Jf., 

154, 167/., 359 Jf- 
Deviations from the normal, 73, 372, 

474- 
Diabetes insipidus, 101. 
Diagnosis, 145, 162, 178, 403, 475, 611, 

619. 
Diagram of endowments, 369. 
Diagram of social strata, 64, 72. 
Dictation (test), 335. 
Didactic material (Montessori), 470. 
Diet, 237, 62g, 653, 682. 

diet for epileptics, 678 /. 
Dietary, 579. 

Differentiation, 17, 31, 65, 377, 441. 
Difficult children 8, 484, 491. 
Digestion, 101, 679/. 
Digestive disturbances, 56, 100 /., 

103, 1 54, 679/. 
Diphtheria, 640. 
Directions, following, 321. 
Discipline, 97, 103, 142, 165, 484, 488, 

506, 673, 680. 
Discrimination (test), 347. 
Diseases, 207, 237, 281, 429/., 579/., 

680. 
Disobedience, 152, 433, 489. 
Dissected pictures, 353. 
Dissipation, 39, 138. 
Distinguished dunces, 92. 
Divorce, 224, 407, 493. 
Dizziness, 101, 154. 
Dolan, Judge, 203. 
Doll play, 417, 426 Jf. 
Domestic work, 522. 
Domesticated minds, 178. 
Donaldson, H. H., 703. 



Dots, 100, 355/. 

Doyle, J. H., 346. 

Dramatic instinct, 208, 427, 468, 513. 

Dramatizations, 513, 516. 

Drawing, 359 J"., 520. 

Dreams, 134, 153, 198, 207, 671. 

Drink, incorrect, 653. 

Drug habit, 688. 

Drugs, 56. 

Drunkenness (cf. alcoholism), 39, 204, 

222, 697. 
Ductless glands, 70, 632 jf., 639, 643, 

656/. 
Duels, 189, 212. 
Dullard, 452. 
Dulness, 13, 70, 163, 386, 430/., 580, 

581, 597- 
Dumb, 62, 382 Jf., 609 Jf. 
Dysgenetic form, 572. 
Dystrophies, infantile, 636, 639. 

Ear, 640. 

Early marriages, 405 jf. 

Eastland disaster, 185. 

Eccentricity, 72. 

Echolalia, 103. 

Economic pressure, 58, 202, 227. 

Economic problems, 14, 164. 

Economically submerged children, 8. 

Eczema, 632. 

Edinburgh, 579. 

Edison, Thomas, 92. 

Education, 1 jf., 10, 16, 47, 70, 197, 

210, 227, 376, 420, 425, 439, 534, /., 

573, 581, 611. 
education and national ideals, 

3 Jf- 
Educational clinic, 113, 158, 268 jf., 

277. 475- 
Educational expert, 273. 
Educational status, 370/. 
Educational tests, 237, 291 jf. 
Efficiency, 18 jf., 44, 67, 74, 80, 82, 
87, 106, 156, 176, 183, 267, 325, 
39i, 44i. 548. 

standards of efficiency, 18, 28, 

248. 
efficiency experts, 18, 28. 
efficiency tests, 18. 
efficiency and skill, 18. 
efficiency and normality, 86. 
manual efficiency, 101. 
training for efficiency, 508. 
Efforts, 646. 
E-fork test, 298. 
Egyptian art, 360 /. 
Ehmination, 654. 



752 



INDEX 



Ellis, Dr. Frederick W., 167. 

Ellis Island, 230. 

Embryonic life, 635. 

Emotion, 138, 165, 359, 490, 513. 537. 

665 ff., 697. 

lack of emotion, 201. 
Emotional states, 142, 149, 151. 
Endowments, 12, 19, 58, 368/. 

combination of endowments, 26, 
42. 
England, 481, 499. 
Enrichment of course, 377. 
Enuresis, 632, 636, 682. 
Environment, 18, 44, 62, 66, 118, 136, 

140, 164, 173/-, 210/., 373, 405/., 

418 ff., 571 JT-. 634/-, 687, 698. 
Epilepsy (epileptics), 62, 104, 152, 

231. 271, 382, 502 /., 636, 639, 

677 ff- 

epilepsy and crime, 199, 697. 
Epiphyses, 636. 
Equilibrium, 69, 72, 122/., 138, 153, 

681. 
Eroticism, 132. 
Eskimos. 171, 200. 
Essentials, 442. 
Ethical (element), 142, 373. 
Ethical Culture School, 450, 564. 
Ethnic, 136, 137. 
Ethnological research, 272. 
Etiological data, 233. 
Eugenics, 38, 230, 373, 393 ff., 576, 

644, 735 /• 
Europe, 219. 
Everson, Geo., 553. 
Evolution (individual), 40, 42. 
Examination for high school, 448 /. 
Examinations, 92. 
Example, 210, 420, 463, 687, 698. 
Exceptional children, 8, 15/., 52, 372, 

5 59, 680, 681. 

exceptionally bright children, 8, 

16, 106/., 392. 
teachers for exceptional children, 

543- 
Exceptional development, 230 jf., 

S7i. ff. 
Excitability, 102, 104 
Excluded children, 382. 
Exercise, 590 ff., 627, 629, 654, 662 /. 
Experience, 367, 420, 489/., 509/. 
Experiment, 440. 
Expression, 359 JF., 44°, 5*3- 
Eyes, 9, 97, 103, 580. 

Factory methods, 27 J"., 175/. 
Facts vs. imagination, 468. 



Facts vs. interpretation, 96. 
Faeces, 101. 

Failures, 2, 6, 7, 9, 10, 14. 
"Fall" of girls, 221 J". 
Fall River, 559. 
Family, 165, 213/ 
family data, 23 1 /. 
family government, 433. 
family histories, 402 ff. 
family traits, 65, 213/. 
Family physician, 427. 
Farm schools, 212, 378. 
Farnell, Dr. Frederic J., 154 Jf., 645. 

704. 
Farrell, Elizabeth E., 159. 
Fatherhood, 405 ff., 413, 437. 
Fathers, 405/., 427. 
Fatigue, 102, 133, 152, 367. 
fatigue period, 117, 428. 
Faucett, blind postmaster-general, 

622. 
Fears, 61, 153, 207, 669 Jf. 
Feeble-minded deaf, 617. 
Feeble-mindedness, 8, 13 /., 36, 38, 50, 
• 63, 6g, 81 /., 123 /., 143, 159 ff., 

193 ff-, 204, 213, 230 ff., 262, 271, 

381 ff., 386, 399 ff., 401, 496 ff., 

698 ff., 73i/. 
Feeling, 487. 
Femininity, 84. 
Fernald, Dr. Walter E., 194, 197, 263, 

499, 699/. 
Fetichism, 427. 
Feuds, 212. 

Field officer, 385, 495/. 
Field of search, 355. 
Field work, 232, 402/. 
Filipinos, 54, 171 /. 
Finger-spelling, 614. 
Fixed ideas, 152. 
Flabbiness, cult of, 547. 
Flatfoot, 580. 
Flegeljahre, 84. 
Flexner, Dr. Abraham, 227. 
Flexner, Mary, 491. 
Food, 627, 653. 
Forcing process, 578. 
Ford, Henry, 378. 
Forest schools, 212, 378. 
Forethought, 87. 
Form, 512, 527 ff. 
Form boards, 171, 350 ff. 
Form tests, 354. 
Formal training, 370, 377. 
Formalism, 455. 

Fraser, Prof. D. Kennedy, 347 /. 
Free will, 692. 



INDEX 



753 



Freedom, 455, 465. 

Fretfulness, 103. 

Freud, Prof. Sigmund, ig8. 

Frick, Kathryne, 503. 

Fright, 62, 153, 640. 

Frobel, Friedrich, 92, 417, 425, 

4S6J. 
Frontal region, 135. 
Fulgate, Mary R., 203. 
Fundamental verities, 430. 
Furbush, Edith M., 231. 

G., P. E., ns/, 707 #. 

Galton, Prof. F., 127. 

Gambling, 48, 192. 

Games, 514, 549/., 663. 

Gangs, 206, 209. 

Garrett, Mary S., 502. 

Gastropathy, 661. 

Gauss, Karl Friedrich, 128. 

Gayley, Prof Chas. Mills, 439. 

Genitals, 236, 681 Jf. 

Genito-urinary system, 689. 

Genius, 15, 43, 61, 67, 75, 118, 122 J"., 

127/-, 133. 136, 138, 573- 
Geographical conditions, 50, 52. 
Geography, 526. 
Geometric design, 354. 
Germ plasm, 571. #., 675. 
German pedagogy, 466. 
Germany, 88, 481, 673. 
Gerry Society, 553. 
Gifts (kindergarten), 357. 
Girls, 82 ff.. 213 ff.. 221, 256, 417, 682. 
Glogau, Dr. Otto, 148, 599, 704. 
Gnawing fox, 667. 
God, 436. 
Goddard, Dr. H. H., 159 /., 162, 168, 

170, 175, 251, 350. 
Goethe, 127, 281. 
Goodhart, Dr. P. S., 128/. 
Goodnow, Judge, 222. 
Government, 175. 
Grades, 441. 
Graft, 203. 
Grant, Ulysses, 121. 
Graves, Floyd, 290. 
Greeks, 200. 
Grief, 580. 
Grimaces, 103. 
Grip, 101. 

Group backwardness, 49, 58. 
Groups, 441. 
Growing pains, 101. 
Growth, 136 /., 164, 167, 238, 427, 

440, 460. 

retarded growth, 62, 105, 580. 



capacity for growth, 87, 89. 
principles of growth, 99. 
growth periods, 99, 117. 
accelerated growth rate, 107 ff. 
Gutzmann, Dr., 608. 

Haberman, Dr. J. Victor, 142. 
Habit, 23, 153, 211, 419/-, 487/-, 597, 
648, 673, 688, 692. 

habit formation, 69, 487 /. 

habit tics, 103, 153, 639. (Cf. tic.) 

habit training, 153. 
Habits of living, 626 ff. 
Habitual constipation, sgo. 
Hackel, Prof. Friedrich, 164. 
Haines, Prof. Thomas H., 197, 495. 
Hair irregularities, 636. 
Hall, G. Stanley, 137. 
Halleck, Reuben Post, 20. 
Hallucinations, 153. 
Hammerberg, 701. 
Handicaps, 98, 572. 
Hardening, psychic, 674. 
Harikari, 193. 
Harris, Dr. Wm. A., 463. 
Haskell, Ellen M., 432. 
Hastings' Manual of Physical Mea- 
surements, 285 JF. 
Haydn, Josef, 127. 
Head injuries, 680. 
Headache, 97, 101, 103. 
Headlong marriages, 407. 
Health, 427, 571. 
Health aspect, 375. 
Health inspection of schools, 494. 
Healy, Dr. Wm., 195, 332, 350 ff., 

353. 490, 647, 700. 
Hearing, g7, 602 jf. 

defective hearing, 9, 61, 96, 103, 
144, 148, 482, 600 ff., 610 ff., 
689. 

hearing tests, 304/-, Si3- 
Hearst, Wm. Randolph, 185. 
Heart, 100, 681. 

Height of children, 284 J"., 431, 580. 
Heine, Heinrich, 394. 
"Herbart Hall," 121, 130/., 243, 276, 

463 /•, S9o. 
Herbart, Joh. Fried., 40. 
Hereditary weakness, 626 Jf. 
Heredity, 19, 42, 58, 62, 118, 136, 140, 
I74> 213 jf-, 393 ff-, 399 ff-, 418 ff., 
427, 57i ff; 63s. 692, 735/- 
Hetherington, C. W., 445 ff., 486. 
Hiatt, James S., 205. 
High school, 442. 
Hines, Albert B , 549 ff. 



754 



INDEX 



Histological studies, 701 f. 
Historical influences, 58. 
History, 527. 

history teaching superficial, 3. 
Hoag, Dr. Ernest Bryant, 242. 
Hoch, Dr. August, 649 /. 
Hollander, Dr. Bernard, 142. 
Holmes, Oliver Wendell, 575. 
Home, 165, 210, 227, 373, 398. 

home activities, credits for, 450. 

home education, 409 Jf., 611 jf. 

home life, 409 JF. 

home-making, 520. 

home problems, 736/. 

home schools, 212, 377/. 

home visitors, 583. 
"Honest Tom," 422. 
Hormone-therapy, 638. 
Hoyt, Justice Franklin C, 551. 
Huey, Dr. E. B., 162, 163, 253 jf., 330, 

332. 
Human raw material, 5 f , 496. 
Human society, 72, 74. 
Human species, 65. 
Hydrocephalics, 63, 639. 
Hygiene, 427/., 430, 580, 723/. 
Hypermetropic, 618. 
Hyperthymism, 148. 
Hypoplasia, 635 J. 

Hysteria, 61, 104, 152, 198, 639, 659, 
668. 

Ideals, 646. 

Ideas, 666. 

Ideas, train of, 316. 

Idiots (idiocy), 63, 70, 160 $., 619, 

630- 
Idiots-savants, 123, 124. 
Idleness, 203. 
Idols, 427. 

Idols of education, 439. 
Ignorance, 215. 
Igorot, 171. 
Illegitimacy, 227. 
Illegitimate children, 395. 
Illegitimate mating?, 395/. 
Illiteracy, 181, 325. 
Illness, 482. 
Illusions, 153, 349. 
Images, 132/. 

Imagination, 61, 104, 207, 468, 659. 
Imbeciles, 63, 70, 160 jF., 193/., 694. 
Imitation, 317, 420, 462. 
Immigration (immigrants), 11, 22, 

57, 164, 181, 483, 493. 
Immorality, 692. 
Immunity (racial), 573. 



Impulses, 36, 45, 54/., 132, 198, 209, 

219, 222, 227, 488, 646, 697. 
Impulsive immoral, 694 ff. 
Inarticulate sounds, 601 Jf. 
Inattention, 104. 
Inaudi, 123. 
Incendiaries, 198. 
Incorrigible, 212, 384 Jf., 491. 
Increment, 19 f., 36. 
Indians, 171, 360/. 
Indigent parents, 494. 
Indigestion, 103, 689. 
Individual child, 12, 373. 

individual adjustment, 58. 

individual attitude, 65. 

individual differences, 13, 376, 
460, 536 /. 

individual efficiency, 33, 489. 

individual evolution, 40, 42, 425. 

individual experience, 367. 

individual problems, 699 jf. 
Individualism, 211 /., 424, 457. 
Individuality, 211, 423. 
Individualization, 644, 699 Jf. 
Industrial problems, 

saving of waste, 5. 

by-products, 6. 

machinery, 21. 

centres of industry, 26. 

localization of industries, 26. 
Industrial schools, 384. 
Inebriety, 39, 204, 222, 697. (C/. 

alcoholism) . 
Ineffectiveness, 14. 
Inefficiency, 434. 
Infancy period, 41, 428, 571 jf. 
Infant mortality, 427. 
Infantile roots, 645. 

infantile conditions, 684/. 
Infantilism, 632, 635, 640. 
Infection, 101, 571, 635, 641, 689. 
Infectious diseases, 429, 581, 640, 

677. 
Inflammation, 101. 
Inherent immoral, 693 Jf. 
Inhibition, 55, 6i, 67, 154, 198, 688. 
Initiative, 87. 
Injuries, 680. 

Insanity (insane), 8, 14, 63, 69, 123, 
142, 162, 173, 197, 677, 680, 694, 
697. 
Insanity scale, 78. 
Insomnia, 102, 665. 
Instincts, 36, 39, 41, 46 f., 58, 70, 
125, 132, 151, 154, 191, 198, 200/., 
207 jj., 217, 222, 229, 416, 426, 
433. 487 1; S 2 °> 646, 697. 



INDEX 



755 



Institutions for exceptional children, 

377, 4.8i I-, 485, 5°4if- 
Instruction, 506, 508 ff. 
Instrumental birth, 640. 
Intelligence, 81, 162, 262, 264/. 

intelligence tests, 150, 263 ff. 
Intemperance, 223, 665. 
Intensity, 154. 
Intercourse, 221, 681. 
Interest, 132, 441, 489/. 
Intermediate period, 42. 
International problem, 138. 
International Sunshine Society, 501. 
Intestinal intoxication, 101. 

intestinal parasites, ior, 689. 
Intoxication. 56, 222. 
Intrauterine life, 571 if. 
Intriguing, 152. 
Inversion, 152, 220, 685. 
Irritability, 61, 103, 688, 697. 
Italy, 219. 
Itard, 700. 

Jacobi, Dr. Abraham, 562, 704. 

Jail, 203. 

James, Prof. Wm., 132. 

Janet, C, 673. 

Japan (Japanese), 138, 193, 66*. 

Jaw-bones, 585/. 

Johnson, Alexander, 262. 

Johnson, Chas. H., 171 JF. 

Johnstone, E. R., 401. 

Joy, 400. 

Judgment, 103, 126, 181, 262, 296, 

318, 667. 

problem in judgment, 345 /. 
Judgment of the examiner, 263. 
Justice, 186. 
Juvenile courts, 195 /., 199, 203 /., 

210, 212, 242, 385, 549 .ff., 692. 
Juvenile delinquency, 185 ff., 491 ff., 

549/., 687. 

Kallikak family, 402. 
Kant, Immanuel, 547. 
Keller, Helen, g7 /., 503. 
Kepler, Joh., 25. 
Kidneys, 101. 

Kindergarten, 137, 357, 455/. 
Knauer, Dr. A., 150. 
Knox, Dr. Howard A., 181, 318 ff., 
355, 648, 704. 

Knox Cube Test, 3 18 if. 
Kotelmann, Prof. L., 290. 
Krafft-Ebing, R. von, 697. 
Krans, Dr. Edw. S., 629, 704. 
Krapelin, Dr. E., 194, 197, 649. 



Kuhlmann, Dr. F., 165. 
Kussmaul, Prof. Ad., 602. 

Labor, care in, 414. 

labor, delayed, 440. 
Laboratories, 377. 
Laboratory work, 519. 

laboratory tests, 235. 
Laisser aller, 388. 
Lamb, Chas., 157. 
Lameness, 61, 482. 
Language, 144, buff. 

language, unacquaintance with, 
93- 

language-making period (in- 
stinct), 132. 

language tests, 325 ff., 255/. 

language teaching, 529. 

language centres, 603. 
Lassitude, 580. 
Law, 395, 552/. 

law vs. crime, 185^. 
Laziness, 103. 

Leaders (leadership), 87, 198, 460/. 
Left-handedness, 101. 
Legal status of child, 374. 

legal aspects, 739. 

legal provisions, 330 ff. 
Leukemia, 10 1. 
Levels, 266. 

Lewis, Dr. F. Park, 618, 705. 
Lichtenheim speech schema, 146/. 
Lindsay, 329. 
Lines, 347. 

Linguistic type, 118, 258/. 
Lip-reading, 305, 611 Jf. 
Literature, 531/. 

Localization of brain functions, 701. 
Location, sense of, 315, 512. 
Loeb, Dr. Jacques, 600/. 
Logical fallacies, 169. 
London, 579. 
London, Jack, 41, 189. 
Longfellow, 119. 
Los Angeles, 692. 
Love, 228/., 394 J"-, 411 ff- 
Lying (lies), 104, 152, 207, 432, 646. 

McCallie's Vision Tests, 298/. 
McCord, Dr. Clinton P., 173. 
McCready, Dr. E. Bosworth, 633, 705. 
McDonald, Arthur, 187, 190. 
McNamara brothers, 48. 
Machinery, 21, 28, 34, 176, 178/. 
MacMurchy, Dr. Helen, 166, 498 if. 
Macrocephalics, 63, 639. 
Mafia, 45. 



756 



INDEX 



Magic square, 346. 

Main, Dr. D. C, 677, 705. 

Majority, 391. 

Make-up, 645. 

Makuen, Dr. C. Hudson, 575, 705. 

Malaria, 101. 

Malays, 172. 

Malnutrition, 93, 100, 103, 164, 428, 

579/.. 689. 
Malocclusion, 584^. 
Malpractice, 225. 
Man, 82/., 415. 
Mangan, 119. 
Manias, 152/., 639, 672 J - ., 676, 687. 

popular manias, 37. 
Manual training, 450, 518. 

manual efficiency, 101. 

manual type, 484. 
Marital relations, 216. 

marital choice, 218. 
Marriage, 137, 218, 230, 393 ff., 493/. 
Mass. Institution for the Feeble- 
minded, 498. 
Mastication, 100, 584 Jf. 
Masturbation, 152, 198, 220/., 681 jf., 

686. _ 
Maternity, see motherhood. 

maternity hospitals. 414. 

maternity nurses, 414. 
Mathematical type, 118, 128. 

mathematical prodigy, 128. 
Matings, 393 ff. 
Maturity (maturing), 54, 65, 82, 84, 

100, 138, 282, 389 ff., 481. 
Mayo, Marion J., 52. 
Measles, 100. 

Measurements, 100, 230/., 283, 580. 
Mechanical construction, 358/. 
Mechanical treatment, 595. 
Mechanism, 667, 675. 
Medical problems, 9, 14, 199. 

medical aspects, 724/. 

medical examination, 233 ff., 
283/., 381, 4.75/- 

medical inspection, 158, 212, 269 
ff., 291, 375, 47s ff, 494. 579- 

medical tests, 23s ff- 

medical treatment, 629 ff. 
Medicoeducational methods, $T$ff. 
Mediocrity, 80, 369. 
Medulla oblongata, 602. 
Mendelian principles, 400. 
Menstruation, 632. 

Memory, 103, 106/., 123, 126/., 135, 
149, 25S, 300 ff., 322, 487, 582, 646. 

memory, aural, 149/., 306 ff. 

memory defects, 102, 150. 



memory, logical, 150, 301. 

memory, motor, 135,315,318, 488. 

memory, visual, 149 /., 300/., 487. 
Mental development, 577. 

mental age, %off., 162, 165, 248, 
251, 262, 389/. 

mental attitudes and aptitudes, 
460. 

mental attitude in defecation, 
S9i /. 

mental condition of epileptics, 
680. 

mental constitutions, 38. 

mental control, 101. 

mental defect, 14, 67 ff., 161, 
430, 481, 498, 636, 640, 688, 697. 

mental disorders, 102, 140, 430, 
568. 

mental habits, 648. 

mental retardation, 105, 164, 685. 

mental status, 232, 282. 

mental tests, 233, 238, 248, 700. 
Mentally defective deaf, 617. 
Merriam, Prof. J. L., 442^. 
Merrill, Rev. Geo. R.. 418. 
Merrill, Dr. Lillian, 204, 232. 
Merzbach, Dr. Joseph, 591. 
Metabolic processes, 681. 
Methodical devices, 470. 
Methods, 132/., 147, 451, 487, 508/., 

540, 575 ff-, 624/., 741/- 
Meumann, E., 70/., 159. 
Mexico, 45. 

Meyer, Dr. Adolf, 151, 635, 649/. 
Microcephalics, 63, 639. 
Middle Ages, 222. 
Midwives, 414. 
Mill, John Stuart, 92, 658. 
Millennium, 545. 
Milton, John, 127, 394, 412. 
Mind, 266, 576. 
Mineral salts, 653. 
Minimum requirements, 364. 
Miscarriages, 233, 280, 410/. 
Misconceptions, 209. 
Misfits, 38. 

Mismanaged children, 61, 95. 
Mistakes, learning from, 87. 
Misunderstanding a child, 432. 
Mitchell, C. A., 203. 
Mixed types, 63. 
Mobs, 55. 
Modelling, 364. 
Modern life conditions, complexity 

of, 21. 
Moll, Dr. Albert, 225 /. 
Mongolia, 188. 



INDEX 



757 



Mongolian idiocy, 639. 

Montessori, Dr. Maria, 73, 458 Jf., 700. 

Moods, 154. 

Moore, Dr. Ross, 692, 705. 

Moral imbeciles, 63, 166, 168, 194, 697. 

moral defects, 430. 

moral insanity, 197. 

moral perverts, 63. 

moral problems, 734/. 

moral sense, 694. 

moral standards, 200. 

moral status, 281. 
Morbid sexuality, 219. 
Morell, Edward, 6, 189. 
Morons, 70, 160, 162, 165/. 
Morris, Judge, 397. 
Morse, Dr. Josiah, 171. 
Mortgaged inheritance, 136. 
Mothercraft schools, 95, 418. 
Motherhood, 214, 405, 416 Jf. 
Mothers' clubs, 95. 
Mothers' pensions, 392. 
Motion, 135, 490, 620. 
Motives, 66, 490. 
Motor defects, 572, 697. 

motor centres, 135, 147, 149, 
3i5, 488. 

motor co-ordination, 314/., 318. 

motor disturbances, 61. 

motor ideas, 125, 134. 

motor problems, 599. 

motor training, 488, 518. 

motor type, n8, 484. 
Mouth, 583 Jf. 

mouth breathing, 586. 

mouth hygiene, 627. 
Moving pictures, 211, 377, 555. 
Mozart, Wolfgang Amadaeus, 127. 
Miiller, Arno, 144 Jf. 
Multiplication, 451. 
Munk, Prof. H., 125, 136. 
Muscular sense, 97, 315, 602. 

muscular control, 101. 
Musculature, 236. 
Music, 512 /. 
Musical prodigy, 123, 127. 

musical type, 86. 
Mutter- und Koselieder, 465. 
Myers, Dr. C. S., 73. 
Myopia, 619. 
Mythologjr, 217. 
Myxcedematous, 632, 639. 

Naivete, 201, 219. 
Naming period, 132. 

naming instinct, 132. 

naming of objects, 324. 



Napoleon, 186, 199. 
Nasal obstructions, 9, 636. 

nasal infections, 640. 
Nascent periods, 132. 
Natal influences, 571 Jf. 
National Ass'n for the study and ed- 
ucation of exceptional children, 113, 
121, 128, 233. 
Nat'l Consumers' League, 412. 
Nat'l Education Association, 388. 
Nat'l League of Compulsory Educa- 
tion Officials, 493. 
National type, 2. 

national consciousness, 2. 

national ideals, 3, 29. 

national growth, 5. 

national competency, 29. 

national endowments, 29. 

national efficiency, 29, 88. 

national organizations, 30. 

national tendencies and the pub- 
lic school, 31. 
Nation-forming period, 42, 65. 
"Natural education," 112. 
Natural selection, 387. 
Nature study, 525. 
Naughtiness, 61, 95, 154, 201, 426. 
Nausea, 154. 
Needlework, 519. 
Negativism, 61, 103, 152. 
Neglected children, 61, 93, 483. 
Negritos, 171. 

Negro, American, 52 Jf., 171. 
Nervous children, 8, 61, 66, 69, 100, 
103, 597. 64S Jf- 

nervous disease, 103. 

nervous disorders, 9, 66, 102 f., 
727 Jf- 

nervous strain, 103, 151. 

nervous system, 99, 122. 
Neurasthenia, 103, 122, 151 /., 198, 

673, 676. 
Neurology, 122. 

Neuromuscular education, 596 Jf. 
Neurons, 6i8.#\ 
Neuropathic, 122, 136. 
Neuropsychosis, 122. 
Neuroses, 573, 635, 639. 
Neurotic, 122, 200, 388, 645 Jf. 
Neustadter, Dr. M., 639, 705. 
Newark, 498. 
New Jersey, 497 Jf. 
N. J. Commission for the Blind, 

502. 
Newton, 128. 

New York, 498, 501, 549 Jf., 580. 
Nietzsche, Friedrich, 75. 



758 



INDEX 



Night terror, 669, 676, 680. 
Nitrogenous, 653. 
Nomadic instinct, 207. 
Non-conforming, 391. 
Non-pathological brightness, 117, 126, 

128. 
Normal children, 8, 60, 65, 70, 72, 

77 Jf-, 89. 559- 
Normality, 53, 64, 66, 6g, 77 $., 161, 

373 /•. 39°, 577 /•■ 639. 
Normality scales, 78. 
Norway, 481. 

Nosworthy, Prof. Naomi, 324. 
Number concept, 148, 336 jf. 
psychology of number, 149. 
number work, 527. 
Nursery, 425, 430. 
Nurses, 385, 478. 
Nutrition, 427, 581 jf. 

Obedience, 103, 432/., 458, 488 J". 

Obesity, 632. 

Objective methods, 466 /., 488, 509, 

598. 
Obscene, 217 Jf. 
Observation, 458, 505. 

early observation, 100. 

observation classes, 180, 241, 

277, 478/, 483- 
Observational attitude, 96. 
Obsessions, 61, 152, 153, 672. 
Obstetrics, 414, 574. 
Occlusion, 584 jf. 
Occupational precautions, 627/. 

occupational efficiency, 87. 

occupational schools, 212. 

occupational training, 518. 

occupational types, 85, 441. 
Occupations for the deaf, 615. 
Odum, Howard W., 52. 
Old World, 200. 
Olson, Chief Justice, 203. 
One-sided development, 118. 
Ontario, 498 /. 
Ontogeny, 164. 
Onuf, Dr. B., 590, 705. 
Open-air schools, 479, 501, 582, 629 Jf., 

653. 

open-air work, 377. 
Opotherapy, 633. 
Oppenheimer's formula, 580. 
Opportunity, 12, 42, 391, 405/., 483/., 

545- 

opportunity classes, 484. 
Opposites, 332. 
Oral hygiene, 583 ff. 
Oral language, 325 jf. 



Organization, problem of, 372. 
Organotherapy, 637. 
Orientals, 193, 200, 218. 
Orthopedic work, 479. 
Osborn, Thomas Mott, 6, 378. 
Osier, Sir Wm, 568. 
Otis, Dr. Margaret, 256. 
Otitis, 621. 

Outdoor (open-air) schools, 629 Jf. 
Ovarian, 632. 
Over-age pupils, 79. 
Overexertion, 103. 
Overintensity, 664. 
Overstimulation, 580. 
Oxygenation, 586. 

Pain, 666. 

Painting, 364, 517. 

Palate, high-arched, 636. 

Panics, 55. 

Paradise of childhood, 487. 

Paragenetic variations, 572. 

Parallelism (culture epochs), 40 Jf., 

359 Jf., 425, 457- 
Paralytic children, 62, 639. 
Parasites, 101. 
Parental schools, 212, 243, 277, 378, 

384, 482, 494. 

parental efficiency, 87. 
parental relations, 216 Jf. 
Parenthood, 411, 416. 

training for parenthood, 95. 
Parents, 100, 137, 165, 208, 215 jf., 

221, 376, 382 /., 387, 391, 405 jf., 

419, 422 Jf., 493 /., 611 Jf., 646/. 
Partridge, Dr. G. E., 222. 
Passion, 394/. 
Passive influences, 420. 
Paterson, Donald G., 257. 
Pathological cases, 62, 122, 127 /., 

135. 687. 
pathological complications, 136. 
pathological laboratories, 479. 
Pathology of feeble-mindedness, 698 Jf. 
Pathos, 665. 

Patrick, Prof. G. T. W., 190. 
Pavor nocturnus (night terrors), 

676. 
Pearson, Dr. Karl, 399, 563. 
Peasants, 47, 51, 200. 
Pedantry, 455. 
Peg-board, 321. 
Penal institutions, 212. 
Perception, 596. 
Perfection, 545. 
Performance level, 20 jj., 26, 33, 39, 

67, 74, 87, 249/. 



INDEX 



759 



Periods of development, 40 Jf., 99, 
117, 154, 164 Jf., 209, 238, 249, 
367/-, 375, 425- 
Persians, 54, 188. 
Personal equation, 250/., 263. 
Personal liberty, 47. 
Personality, 197, 209, 211, 540, 645. 
Perversion, 213 Jf., 687, 697 (cf. sexual 

perversion). 
Perverts, 8, 61, 63, 152, 199. 
Pestalozzi, 25, 466. 
Peterson, Church and, 135 /. 
Petit mal, 104. 
Philadelphia, 481. 
Philippines, 171 /. 
Phimosis, 636, 682. 
Phobias, 668/., 676. 
Phylogeny, 164. 
Physical training, 514 jf. 

physical causes, 652. 

physical examination, 283 Jf. 

physical handicaps, 9, 37, 61/., 
93, 164, 482, 567, 579, 580, 621, 
629/., 722 /. 

physical tests, 180. 
Physically defective children, 62, 722/. 
Physicians, 232, etc., 575, 577 Jf. 
Physiological tests, 237. 

physiological age, 99, 167, 285. 

physiological conditions, 723. 

physiological function, 102, 180. 
Physiopsychological tests, 233, 237. 
Pictographs, 462. 
Pictorial completion test, 351 Jf. 
Picture-arrangement test, 347 Jf. 
Picture cubes, 353. 
Pictures, 251, 326, 347. 
Pictures, dissected, 353. 
Pineal gland, 633 Jf. 
Pinel, 700. 

Pintner, Rudolf, 257. 
Pioneers, 25. - 
Pittsfield, Mass., 559. 
Pituitary gland, 632, 633 jf., 656/. 
Planning, 87. 
Plastic infancy, 431. 
Plasticity, 87. 
Play, 42 6 #.,487, 550/. 

play school, 445, 486. 
Playgrounds, 206, 210. 
Pleasure, 666. 
Pneumonia, 640. 
Pohler, Otto, 125 Jf., 128. 
Point scale, 251. 
Poise, 61, 72, 198. 
Police, 6, 49, 212. 
Policeman, 552 Jf. 



Poliomyelitis, 640. 
Political, 421. 

political equality, 12. 

political influences, 58. 

political oppression, 51. 
Pool-rooms, 558. 
Pope, 394. 

Population, shifting of, 10. 
Positive assets, 82. 
Postnatal, 571, 635, 640. 
Posture. 518, 636. 

Potential normality, 14, 17, 66, 74, 82, 
90 Jf., 104, 386. 

potential competency, 42. 

potential failure, 9, 50. 
Potentials. 20, 66, 72, 97, 489. 
Poverty, 49, 202, 383, 493. 
Practice with children, 542 Jf. 
Precautions, 627 Jf. 
Precocity, 61, 100, 103, 136/., 430/., 

485, 573. 695- 
Predementia praecox, 132, 151, 648. 
Predispostion vs. heredity, 626. 
Pregnancy, 412, 574. 
Prejudice, 229. 
Prenatal influences, 153, 163 /., 174, 

571 Jf; 635, 64O. 

Prepubescence, 199. 

Prevention, 372, 374, 391, 563, 576, 

S82, 595- 
Primary (primitive) period, 42, 65, 

170. 
Primitive forms of behavior, 54, 190, 

485. 
Primitive impulses and instincts, 45, 

188, 190/., 201, 222. 
Primitives (types and races), 8, 36/., 

39, 40, 42, 46, 48, 63, 170, 189, 

200/., 485. 
Principles, 211. 
Prisons, 6, 188. 

Pritchard, Margaret S., 257, 259. 
Privacy, 47, 219. 
Private schools, 1, 493. 
Prize-fights, 558. 
Probation, 212, 385, 553 if- 
Procedure. 563. 

Procreation, 217, 229, 396, 405. 
Prodigies, 123 Jf. 
Production, 440. 
Profession of teaching, 539. 
Professional training, 95. 
Progress, 424. 

Promiscuous sex relations, 219 Jf. 
Promotion, 241, 282, 481/. 
Property, 46. 
Prophylactic measures, 644, 649. 



760 



INDEX 



Prospective mothers, 412, 574. 
Prostitution, 48, 152, 173, 199, 213 jf., 

236, 401. 
Protein, 653, 675. 
Protoplasm, 665, 675. 
Providence, R. I., 481. 
Provisions for exceptional children, 

383 474, 481/., 569/. 
Prudishness. 215, 229. 
Pseudo-(par-)atypical children, 8, 61, 

71, 90 jf., 482/., 629. 
Psychasthenia, 122, 672/. 
Psychiatry, 122. 
Psychic epidemics, 37. 

psychic defect, 123. 

psychic disorders, 727 jf. 

psychic disturbance, 606. 

psychic factor, 592. 

psychic mechanism, 604. 
Psychogenetic, 667, 673, 676. 
Psychological conditions, 573. 

psychological age, 99, 285. 

psychological aspects, 725 Jf. 

psychological causes, 652, 657. 

psychological clinic, 269 Jf., 479. 

psychological disorders, 102. 

psychological employment, 692. 

psychological tests, 269 J"., 291 Jf. 
Psychology, genetic, 269 Jf., 455 /., 

S4i f. 
Psychomotor, 676. 
Psychoneuroses, 669, 676. 
Psychopathic clinic, 157, 271 Jf., 479. 

psychopathic constitutions, 141 

jr., 640. 

psychopathic personalities, 197 

jr., 648. 

psychopathic problems, 14, 37, 

55, 58, 61, 69, 102, 122, 140 Jf., 

197 Jf., 207 /., 485, 573, 645 Jf. 

Psychopathology. 651, 657, 675. 

Psychophysical education, 577. 

Psychoses, 61, 69, 102, 122, 635, 639, 

676. 
Psychotherapy, 122. 
Pubertal development, 581. 
Puberty, 65. 117, 152, 198, 636. 
Pubescence, 137, 199. 
Pubescent period, 42, 65, 429. 
Pubic hair, 235 Jf. 
Public Education Association, 68. 
Public schools, 1 jf., 14. 

critics of public schools, 1 Jf., 10. 

community problems, 5. 

administrative problems, 10. 

national tendencies, 31. 

variation of standards, gof. 



Punishments, 97, 188, 646. 

Purin, 653, 675. 

Puritanism, 214. 

Puzzles, 329 Jf., 346, 353, 529/. 

Pygmies, 171. 

Pyle, Prof. Wm. Hy., 290, 367. 

Pyromaniacs, 198. 

Qualities (tests), 332. 
Quality, intellectual, 20, 264. 
Quantitative analysis, 72. 

quantitative measurements, 248. 
Quick children, 484. 

Race development, 425. 
Race period, 42, 65. 
Races, backward, 43, 54. 

races, mixed, 4. 
Racial causes, 164, 171 Jf., 272, 483, 
488, 573- 

racial elements, 192, 572 Jf. 

racial problems, 737 Jf. 

racial standards of normality, 
85. 459- 

racial types, 73, 93, 193, 223 /., 
458. 
Rape, 199. 

Rapid development, 61, 93, 484. 
Reaction, 55, 153. 
Reading, 125, 144, 148, 256, 325, 334, 

44o, 53i /-, 612. 
Reason, 395. 
Reasoning, 65, 356. 
Reber, Dr. Wendell, 297. 
Recitations, 107, 364. 
Recklessness, 49. 
Records, 232, 504, 712 Jf. 
Recreation, 554. 
Redemption of childhood, 572. 
Re-education, 486. 
Refinement, 47. 
Reflex action, 36, 54, 135, 601. 
Reform schools (reformatories), 197, 

199, 212, 243, 384, 495/- 
Refractive errors, 618 Jf. 
Regimen. 486. 
Reincarnation, 217. 
Relationship, 572. 
Relief of conditions, 70, 374. 
Religion, 217, 222, 373, 437, 556, 673. 
Religious development, 427, 556. 
Repeaters, 11/., 105. 
Repetition, 149. 
Repressions, 646. 
Research, 272 

Reserve mental energy, 132. 
Resistances, 648. 



INDEX 



761 



Resources, 87. 

Respiration, 100, 512, 600, 655. 

Response, 367. 

Restriction of marriages, 394. 

Retardation, 8, 38, 52, 61 /., 81, 104/., 

162, 164, 482, 495, 553, 582, 585, 

636 /., 639. 
Reverberations, 46, 48. 
Reversion, 45, 49, 58. 
Revolution. 45, 175. 
Rheumatism, 101. 
Rhythm, 149, 164, 513, 598. 
Rice, Prof. David Edgar, 133. 
Richter's anchor stone building-blocks, 

354, 358. 
Rickets, 594, 632, 680. 
Right-handedness, 101. 
Rigidity of types, 70. 
Rolandic area, 135, 315. 
Romberg position, 316. 
Romer, Dr., 147. 
Rotch, Dr. Thomas M., 235/. 
Routine, daily, 628, 673. 
Riickert, Friedrich, 119. 
Rudimentary development, 63. 

Sacrament of matrimony, 411. 
Sakaki, Yasusaburo, 138, 485. 
Sanatorium schools. 212, 377, 485, 

504#- 
Sanctity of human life, 47. 
San Francisco resolutions, 389. 
Savagery, 187. 
Savages, 36, 425. 
Scale of intelligence, 80. 
Scarecrow eugenics, 393 f. 
Scarlet fever, 100. 
Schedule of examination, 564 Jf. 
Schiller, Friedrich, 395. 
Schmitt, Dr. A. Emil, 563, 705. 
School buildings, 11, 556. 

school census, 494. 

school courses to be broken up, 441 . 

school defects, 94, 205, 376. 

school grades, 79 /., 90 /., 282, 
481/. 

school lunches, 582. 

school nurses, 478, 583. 

school organization, 376. 

school problems, 14, 212, 481 ff., 

739 /• 
school provisions, 481 ff., 743 /. 
school standards, 165, 259, 441. 
school success not a safe standard, 

80, 106. 
school training 367, 621. 
school visitor, 478, 491, 583, 



Scientific type, 118. 

Scott, Walter, 92. 

Scout movement, 549. 

Scripture, May Kirk, 148. 

Scruples, 672. 

Scrupulosity, malady of, 673. 

Seattle, 196, 204. 

Second breath (second wind), 132 /., 

137- 
Secret languages, 329^". 
Sedentary habits, 686. 
Seguin, Dr. Edouard, 350, 700.//'. 
Self, 134. 

self-centredness, 104, 123, 151, 
157- 

self-consciousness, 490. 

self-control, 154. 

self-expression, 463. 

self-repression, 151. 
Selfishness, 48, 104, 141, 190. 
Sella turcica, 636. 
Sensation, 135, 620, 666. 
Sense training, 466/., 511 /. 

sense perception, 295 ff., 425. 

sense reactions, 97, 153. 
Sensory defects, 96, 572, 639. 
Sensory diet, 61, 153. 
Sensory nuclei, 619. 
Sensory type, 118. 
Settlements, 555 jf. 
Sewing, 519. 
Sex differences in attitude, 84. 

sex glands, 632. 

sex instinct, 151 /., 198, 217 ff., 
2ig, 681, 685. 

sex-organs, 236 /., 681 ff. 

sex, shame of, 674. 

sex- worship, 222/. 
Sexual neurasthenia, 151, 220, 674. 

sexual abnormalities, 213 ff., 
683 #.,697- 

sexual development, 215 ff., 557, 
685. 

sexual differentiation, 65. 

sexual education, 216, 396, 683. 

sexual hygiene, 216, 396, b&iff. 

sexual morbidity, 132, 152. 

sexual perversion, 213 ff., 685, 
688. 

sexual precocity, 152. 

sexual problems, 61, 70, 100, 199, 
200, 734/., 684. 

sexual relations, 47. 
Shakespeare, 411. 
Shame, 672, 685. 

shame of sex, 674. 
Shiels, Prof. R. Thomas, 452. 



762 



INDEX 



Shop-work, 518. 
Shuttleworth & Potts, 470. 
Shyness, 674. 
Siberia, 189. 
Sickness, 202 /. 

Sidis, William James, 128 f., 658. 
Sight, defective, 618 $., 689 \cf. vi- 
sion). 
Sign-language, 614. 
Signe du sourcil, 636. 
Simple life conditions, 487. 
Simpler mental constitutions, 38. 
Singhalese, 171. 
Singing, 364, 513. 
Sitting up, 100. 

Situation, understanding of, 87, 296. 
Skeleton, 235. 
Skill, 18JF., 44, 70, 80, 107, 176. 

skill vs. efficiency, 18, 23/., 183. 
Slander, 152. 
Sleep, 103, 153, 626, 629. 
Sleeping-porch, 626. 
Slocum disaster, 185. 
Slow children, 16, 61, 91, 391, 482, 

484. 
Slums, 164, 174, 219. 
Smaller classes, 483. 
Smedley, F., 290. 
Smell, 97, 312/. 
Smile, 100. 

Snellen test-cards, 299. 
Social centres, 555 ff. 

social conscience, 211, 457. 

social efficiency, 88, 177/. 

social oppression, 51, 58. 

social problems, 14, 173 if., 210/., 
272, 549/-, 58o, 644, 737 /■ 

social timorousness, 674/. 

social visitors, 478. 
Society, 36, 211, 422, 559. 
Sociological investigation, 480. 
Sociologist, 495. 
Somnambulism, 153. 
Sound tests, 306. 
South Sea Islanders, 54. 
Southard, Dr. E. E., 698, 705. 
Souvenir craze, 192. 
Space, 134, 149, 527. 
Space conception, 337 Jf. 
Spain, 219. 
Special education, 573, 743 /. 

special bent, 441. 

special children, 481 Jf. 

special classes, 382, 481 ff., 490, 
S82. 

special defects, 572. 

special schools for the blind, 623. 

special schools for truants, 494. 



Specialization of labor, 21. 

specialization in teaching, 53S. 
Specialties, 120. 
Speech, 100, 578, 599 Jf., 610 jf. 

speech centres, 103, 144, 603. 

speech clinic, 609. 

speech conflict, 148. 

speech defects, 102, 144, 148, 
574, 609. 
Speed as an element of weakness, 92. 
Spelling (test), 335, 532. 
Spencer, Herbert, 92. 
Spinal cord, 135. 
Spirit of the home, 436. 
Spiritual growth, 217. 

spiritual life, 436. 

spiritual truth, 217. 
Spoiled children, 61, 95. 
Sport, 211. 

Springfield examination papers, 444. 
Squint, 580, 618. 
Stability, 122. 
Stamina, 122. 
Stammering, 148. 
Standardization, 248^". 
Standards, 372, 456. 
Stand up, 100. 
Static apparatus, 316. 
Statistical purposes, 72. 
Stecher, W. A., 138. 
Steffens, Lincoln, 422. 
Stelzner, Dr. Helenefriederike, 141. 
Stereognostic sense, 620. 
Stereotyped forms in kindergarten, 

455 /■ 
Sterilization, 394 J"-, 398 J". 
Stern, Prof. Wm., 257. 
Stevenson, Robert Louis, 49, 394. 
Stigmatizing, 482. 
Stiles, C. W., 290. 
Still-births, 233, 280, 410/. 
Stimulants, 627. 
Stimulation, 137. 
Stock (human), 136. 
Stock-farm eugenics, 393 /. 
Stoll, Otto, 225. 
Stoner, Winifred Sackville, Jr., 108 Jf., 

125, 658. 
Story-telling, 326. 
Strain, 151. 

Strata of civilization, 49, 58, 74, 173/. 
Street, 210, 219, 438, 550 Jf. 

street-land, 551. 
Struggle for existence, 23, 45. 
Stupidity, artificial production of, 452. 
Stuttering, 148, 513, 606/. 
Subconscious, 134. 
Subjects of instruction, 536. 



INDEX 



763 



Submerged group, 58, 63. 
Subnormal children, 8, 62, 66 Jf., 70, 

98/., 374,485- 
Substitution, 676. 
Success, 186. 

Suggestion, 133, 157, 659. 
Suicide, 56, 673. 
Summary, 366, 712 Jf. 
Superstitions, 47, 673. 
Suprarenal, 633. 
Surgical treatment, 596. 
Survivals, 58. 

survival of the fittest, 388. 
Swann, Judge Edward, 495. 
Switzerland, 481. 
Syllabus for special classes, 491. 
Symbolic period, 469. 
Symbolism in the kindergarten, 455 

#.,461/. . 
Symbols of reality, 441. 
Sympathy, deficiency of, 696. 
Symptoms, 96. 
Syphilitic infection, 70, 100, 635, 

64°/-, 701. 
Syracuse, 498. 

Table manners, 47. 
Tactile tests, 311/. 
Tainted heredity, 405. 
Talking, 100. 
Tantrums, 153. 
Tanzi, 693 jF. 
Taste, 97, 314. 

Teachers, 94, 455, 458 /., 466, 509, 
533 ff- 

training of teachers, 94, 376, 
483, 533 Jf- 
Teeth, defective (cf. dental), 9, 100, 
568, 580, 584, 653, 688. 

teeth, Hutchinson's, 100. 
Temper, 102, 104, 153. 
Temperament, 164. 

changes of temperament, 102. 
Temperamental types, 85, 93. 
Temperature sense, 97. 

ideas of temperature, 512. 
Temptations, 40. 
Tenements, 164, 191, 218. 
Tension, 100, 117, 122, 128, 136, 165, 

190, 198, 285. 
Terman, Prof. Lewis M., 159, 240. 
Terminology, 60 Jf., 71. 
Terrors, 153. 

Tests, 81, 100, 150, 167, 180/., 230 Jf., 
274, 276 Jf., 373, 404, 504 Jf., 639, 
700/., 7IQJT- 
Tic, 61, 103, 153, 667, 675. 
Time, 134, 149. 



Timidity, 152, 490. 

Titanic disaster, 185. 

Theft, 152. 

Thorndike, Prof. E. L., 327. 

Thought, 36, ss, 65, 325, 487/., 666. 

Three R's, 442, 469. 

Throat infection, 640. 

Thumb-sucking, 100. 

Thymus gland, 148, 632, 633 Jf., 657. 

Thyroid, 632 Jf., 657. 

Tobacco, 152. 

Toepel, Dr. Theodore, 626, 705. 

Tokyo, 485. 

Tone tests, 306/. 

Tonsils, 586 Jf., 621, 688. 

Tools, 440, 518. 

Toronto, 550. 

Torture, 188. 

Touch, 97, 311/., 512, 602, 619. 

Touch at distance, 618. 

Trabue, M. R., 327. 

Trade schools, 493. 

Tradition, 420. 

Tragedy of woman's life, 214. 

Train of ideas, 316. 

Training, 20, 70, 119, 153, 621 Jf. 

injudicious, 142. 
Traits, 43. 

Transportation, means of, 23. 
Traumatism, 571, 640. 
Treasure Island, 49. 
Tredgold, Dr. A. F., 124, 161, 163, 

167, 180, 266. 
Trophic disturbances, 61, 103, 154. 
Troublesome children, 61, 95. 
Truants, 52, 68, 204 jf., 386, 491 jf., 

549 Jf- 

truant officers, 493. 
truant schools, 241, 384/., 494. 
Truth, 216/. 
Truthfulness, 432/. 
Tuberculosis, 9, 581, 594, 626 Jf., 

635, 640/., 681. 
Tutors, 486. 
Twitchings, 580. 
Types, 12, 15, 20, 35, 61, 70, 74, 85, 

118, 193, 200, 258, 376, 441, 460, 

693- 
Typical children, 61, 71 Jf. 
typical experience, 489. 

Uebermensch, 75. 
Unclassified books, etc., 744 Jf. 
Unconscious elements, 133, 487, 646. 
Unemployment, 204. 
Ungraded classes, 382, 481 if. 
Uniform standard's in kindergarten, 
456. 



764 



INDEX 



United States, 481, 673. 

U. S. Bureau of Education, 383, 386/., 
491. 

University Elementary School (Mis- 
souri), 442 Jf. 

University of California, 447. 

Unskilled labor, 173, 175, 178. 

Unsocial instincts, 210/. 

Unwelcome children, 410/. 

Unwritten law, 212. 

Upheavals, 49. 

Urination, 101. 

Urine, 686. 

Uterus, 632. 

Vagrants, 173. 

Valuation, 373. 

Van Denburg, Dr. M. W., 92. 

Variability, 53, 73. 

Variations, 15 /., 41, 61, 74, 372, 474, 

572. 
Vasomotor disturbances, 61, 103, 154, 

697. 
Vendettas, 212. 
Veneer of civilization, 187. 
Venereal diseases, 396, 407. 
Ventilation, 103. 
Verbal type, 259. 
Vicarious experience, 98. 
" Village of a Thousand Souls," 404. 
Vineland, 350, 401, 498/. 
Virginity, 222. 
Virility, 136. 
Viscera, ptoses of, 636. 
Vision, 97, 295, 602. 
Visiting teacher, 491. 

visiting nurses, 385. 
Visual defects, 9, 61, 96, 103, 482, 
5S0, S Si, 6i8Jf., 636. 

visual memory, 126, 150, 300/., 
487. 

visual perception, 126, 144. 
• visual tests, 295. 
Visualization, 126, 149, 296, 487, 

528. 
Vital capacity, 290, 580. 

vital index, 290. 

vital statistics, 232, 403. 

vital studies, 440. 
Vitalization, 537. 
Vocational training, 31$., 520. 

vocational guidance, 376, 479, 
558. 

vocational problems, 740/. 

vocational types, 441. 
Voltaire, 128. 
Voting cattle, 177. 
Vulgar, 213, 222. 



Wage-earners, 27. 
Wail of the well, 77/. 
Walking, 100, 58g. 
Wanderlust, 207. 
War, 37, 45, 55, 187 Jf. 
Warren, Mortimer A., 436. 
Washington, George, 186. 
Waste, 14/. 

irreducible waste, 14. 
Waverley, 498. 
Weeks, Dr., 399. 

Weight of children, 284 Jf., 431, 580. 
Weight tests, 258, 512. 
Wessels, Dr. Lewis C, 9. 
Westermayr, Arthur J., 153. 
Weysse, Dr. Arthur W., 681, 705. 
Whipple, Prof. Guy Montrose, 367. 
Whispering, 103. 
White man's burden, 54, 173. 
White race, 171 Jf. 
White slavery, 229. 
Whittier, John Greenleaf, 206, 440, 

487.. 
Whooping-cough, 100, 633. 
Wiener, Robert, 108, 658. 
Wilbur, Judge Curtis D., 692. 
Wild West, 191. 
Wile, Dr. Ira S., 571, 579, 705. 
Will, 103, 198, 210, 490, 692. 
William of Orange, 394. 
Williams, Dr. Tom A., 157, 651, 706. 
Winterburn, Florence Hall, 406. 
Witmer, Dr. Lightner, 78, 81. 
Woman, 82 Jf., 214, 415. 
Wood, Dr. Thomas D., 567, 580, 706. 
Word-blindness, 143. 
Word-deafness, 143. 
Word pictures, 307 Jf. 
Work, 662. 
Working boys, 558 Jf. 

working papers, 495, 558. 
Workshops, 377. 
Worms, 689. 
Worry, 580. 

Wright, John Dutton, 610, 706. 
Writing, 126, 148, 256, 325 Jf., 334, 

440. 
Wunderkinder, 124. 

X-Ray pictures, 235, 636. 

Yerkes, Dr. Robert M., 251, 701. 
Y. M. C. A., 549/. 

Zapata, 45. 

Zentler, Dr. Arthur, 5S3, 706. 

Ziehen, 141, 151. 

Ziller, 40. 



